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Giuliani NR, Kelly NR, Budd EL. The role of food reward in the associations between weight-based discrimination and feeding practices among caregivers of young children. Appetite 2024; 201:107620. [PMID: 39098766 DOI: 10.1016/j.appet.2024.107620] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2024] [Revised: 06/19/2024] [Accepted: 08/01/2024] [Indexed: 08/06/2024]
Abstract
Certain caregiver feeding practices, including restrictive feeding for weight control, restrictive feeding for health, emotion regulation feeding, and reward feeding, are known to negatively influence short- and long-term child eating and health outcomes. Beyond body size, the precise psychosocial characteristics of caregivers more likely to engage in such feeding practices are unknown. In particular, caregivers who have experienced discrimination based on their weight, who have internalized those biased beliefs, or who find food to be very rewarding may be more likely to use restrictive or controlling feeding practices. The present study investigated the associations among experiences of weight-based discrimination, internalized weight bias, and food reward (i.e., reward-based eating drive) with use of restriction for weight control, restriction for health, emotion regulation feeding, and reward feeding in an online US sample of caregivers (M = 35.27 ± 9.08 y/o) of 2-5 year-old children (N = 305). About half (50.8%) of respondents self-identified as women and most as non-Hispanic (88.5%) and White (75.1%). There were significant positive correlations among caregivers' experience of weight-based discrimination, internalized weight bias, and use of all four feeding practices. Regression results showed that caregivers' food reward moderated the main effect of weight-based discrimination on restrictive feeding for weight control and emotion regulation feeding, such that caregivers who were high in food reward and who experienced discrimination were most likely to engage in these feeding practices. These results can inform interventions aimed at improving child food environments and health.
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Affiliation(s)
- Nicole R Giuliani
- Special Education and Clinical Sciences, University of Oregon, Eugene, OR, USA; Prevention Science Institute, University of Oregon, Eugene, OR, USA.
| | - Nichole R Kelly
- Counseling Psychology and Human Services, University of Oregon, Eugene, OR, USA; Prevention Science Institute, University of Oregon, Eugene, OR, USA
| | - Elizabeth L Budd
- Counseling Psychology and Human Services, University of Oregon, Eugene, OR, USA; Prevention Science Institute, University of Oregon, Eugene, OR, USA
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2
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Wang Y, Chen Y, Lu C, Kwan ATH, McIntyre RS, Yang F, Cao B. The psychological factors mediating/moderating the association between body-image disturbance and depression: A systematic review. Psych J 2024; 13:527-540. [PMID: 38725387 DOI: 10.1002/pchj.754] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2023] [Accepted: 03/07/2024] [Indexed: 08/13/2024]
Abstract
Available evidence demonstrates that individuals with body-image disturbance (BID) are prone to suffer from depression. This systematic review provides, to our knowledge, the first synthesis of the psychological mechanism of the association between BID and depression. We conducted a thorough search of online databases, including PubMed, Web of Science, and PsycINFO, for articles published up until February 2024. The final analysis comprised a total of 23 studies that focused on the mediating or moderating effects of psychological factors between depression and BID. This review identifies self-esteem and social support as both mediators and moderators of the relationship between BID and depression, while perceived stress acted only as a mediator. High self-esteem and strong social support as well as low levels of perceived stress may help individuals experience lower levels of BID, thereby contributing to a decreased likelihood of depression. Interventions aimed at increasing self-esteem, developing strong support, and decreasing perceived stress may hold promise to reduce the risk of depression in those with BID.
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Affiliation(s)
- Yiyi Wang
- Key Laboratory of Cognition and Personality, Faculty of Psychology, Ministry of Education, Southwest University, Chongqing, China
| | - Yuqi Chen
- Key Laboratory of Cognition and Personality, Faculty of Psychology, Ministry of Education, Southwest University, Chongqing, China
| | - Chenxuan Lu
- Key Laboratory of Cognition and Personality, Faculty of Psychology, Ministry of Education, Southwest University, Chongqing, China
| | - Angela T H Kwan
- Brain and Cognition Discovery Foundation, Toronto, Ontario, Canada
- Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada
| | - Roger S McIntyre
- Brain and Cognition Discovery Foundation, Toronto, Ontario, Canada
- Department of Pharmacology and Toxicology, University of Toronto, Toronto, Ontario, Canada
- Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
| | - Fahui Yang
- Key Laboratory of Cognition and Personality, Faculty of Psychology, Ministry of Education, Southwest University, Chongqing, China
- National Demonstration Center for Experimental Psychology Education, Southwest University, Chongqing, China
| | - Bing Cao
- Key Laboratory of Cognition and Personality, Faculty of Psychology, Ministry of Education, Southwest University, Chongqing, China
- National Demonstration Center for Experimental Psychology Education, Southwest University, Chongqing, China
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Borgatti A, Morgan C, Stager L, Dutton GR. Associations between weight bias internalization, weight status, and health among a diverse cohort of freshman college students. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2024:1-10. [PMID: 38875131 DOI: 10.1080/07448481.2024.2346351] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/15/2023] [Accepted: 04/09/2024] [Indexed: 06/16/2024]
Abstract
Mental health concerns are common among college students, especially students with higher body mass index (BMI). Weight bias internalization (WBI) is thought to contribute to these mental health disparities. However, little is known about how WBI differs among more diverse students, and to what extent WBI may explain associations between BMI and health in college populations. This study compared rates of WBI in Freshman college students (N = 1289) across gender, race/ethnicity, and sexual orientation, and assessed whether WBI mediated associations between BMI and mental health (depression, self-esteem, stress, loneliness) and behavioral health (disordered eating, physical activity, gym use). Black students and men demonstrated reduced WBI while bisexual women showed increased WBI. Further, WBI mediated the association of BMI with mental health and disordered eating, but not physical activity. These findings suggest that stigma may account for mental health disparities among higher-BMI students, and that minoritized groups are disproportionately impacted.
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Affiliation(s)
- Alena Borgatti
- Division of Preventive Medicine, School of Medicine, The University of Alabama at Birmingham, Birmingham, AL, USA
- Department of Psychology, College of Arts and Sciences, The University of Alabama at Birmingham, Birmingham, AL, USA
| | - Casie Morgan
- Department of Psychology, College of Arts and Sciences, The University of Alabama at Birmingham, Birmingham, AL, USA
| | - Lindsay Stager
- Department of Psychology, College of Arts and Sciences, The University of Alabama at Birmingham, Birmingham, AL, USA
- Department of Psychiatry, School of Medicine, The University of Alabama at Birmingham, Birmingham, AL, USA
| | - Gareth R Dutton
- Division of Preventive Medicine, School of Medicine, The University of Alabama at Birmingham, Birmingham, AL, USA
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Glazer SA, Vallis M. Impact of COVID-19 pandemic on sleep parameters and characteristics in individuals living with overweight and obesity. Clin Obes 2024; 14:e12646. [PMID: 38348598 DOI: 10.1111/cob.12646] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/11/2023] [Revised: 01/17/2024] [Accepted: 01/18/2024] [Indexed: 05/14/2024]
Abstract
Coronavirus disease 2019 (COVID-19) has been very challenging for those living with overweight and obesity. The magnitude of this impact on sleep requires further attention to optimise patient care and outcomes. This study assessed the impact of the COVID-19 lockdown on sleep duration and quality as well as identify predictors of poor sleep quality in individuals with reported diagnoses of obstructive sleep apnoea and those without sleep apnoea. An online survey (June-October 2020) was conducted with two samples; one representative of Canadians living with overweight and obesity (n = 1089) and a second of individuals recruited through obesity clinical services or patient organisations (n = 980). While overall sleep duration did not decline much, there were identifiable groups with reduced or increased sleep. Those with changed sleep habits, especially reduced sleep, had much poorer sleep quality, were younger, gained more weight and were more likely to be female. Poor sleep quality was associated with medical, social and eating concerns as well as mood disturbance. Those with sleep apnoea had poorer quality sleep although this was offset to some degree by use of CPAP. Sleep quality and quantity has been significantly impacted during the early part of the COVID-19 pandemic in those living with overweight and obesity. Predictors of poor sleep and the impact of sleep apnoea with and without CPAP therapy on sleep parameters has been evaluated. Identifying those at increased risk of sleep alterations and its impact requires further clinical consideration.
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Affiliation(s)
- Stephen A Glazer
- Department of Internal Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Michael Vallis
- Department of Family Medicine, Dalhousie University, Halifix, Nova Scotia, Canada
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Hunger JM, Montoya AK, Edrosolan K, Tan J, Hubbard AS, Tomiyama AJ. Ecological Momentary Assessment of Weight Stigma and Eating Behavior in Everyday Life. Ann Behav Med 2024; 58:457-462. [PMID: 38591715 DOI: 10.1093/abm/kaae012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/10/2024] Open
Abstract
BACKGROUND Weight stigma is widespread, but the existing literature on its harmful consequences remains largely limited to lab-based experiments and large-scale longitudinal designs. PURPOSE The purpose of this study was to understand how weight stigma unfolds in everyday life, and whether it predicts increased eating behavior. METHODS In this event-contingent ecological momentary assessment study, 91 participants reported every time they experienced weight stigma and documented whether they ate, how much they ate, and what they ate. These reports were compared against a timepoint when they did not experience stigma. RESULTS Participants reported a wide variety of stigmatizing events from a variety of sources, with the most common ones being the self, strangers, the media, and family. Multilevel models showed that participants were no more likely to eat post-stigma (vs. the comparison point), but if they did eat, they ate more servings of food (on average consuming 1.45 more servings, or 45% more). Moderation analyses indicated that this effect was amplified for men versus women. CONCLUSION Experiencing weight stigma appears to beget behavioral changes, potentially driving future weight gain, placing individuals at ever more risk for further stigmatization.
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Affiliation(s)
| | - Amanda K Montoya
- Department of Psychology, University of California, Los Angeles, Los Angeles, CA, USA
| | - Kristienne Edrosolan
- Department of Psychology, University of California, Los Angeles, Los Angeles, CA, USA
| | - Juanyi Tan
- Department of Psychology, University of California, Los Angeles, Los Angeles, CA, USA
| | - Anne S Hubbard
- Department of Psychology, University of California, Los Angeles, Los Angeles, CA, USA
| | - A Janet Tomiyama
- Department of Psychology, University of California, Los Angeles, Los Angeles, CA, USA
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Figueroa DG, Parker JE, Hunger JM, Kraus MW, Muscatell KA, Tomiyama AJ. Social class stigma and poorer health behaviors: Evidence from the eating in America study. Soc Sci Med 2024; 347:116765. [PMID: 38492265 DOI: 10.1016/j.socscimed.2024.116765] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2023] [Revised: 02/19/2024] [Accepted: 03/05/2024] [Indexed: 03/18/2024]
Abstract
Although the association between objective markers of low socioeconomic status (SES) and poor health is well established, one underexamined possibility is that over and above objective SES, social class stigma-experiences and anticipation of discrimination based on social class-might undermine people's ability to engage in healthy behaviors. Participants (N = 2022) were recruited between December 2019 and January 2020 via a national Qualtrics panel that was census-matched to the U.S. population in age, gender, income, race/ethnicity, and census region. Participants completed measures of class stigma, alcohol use, disordered eating, comfort eating, sleep disturbance, physical activity, and demographics. Controlling for objective SES and demographics, generalized linear regression models indicated that class stigma was associated with significantly greater alcohol use, disordered eating, greater comfort eating, and sleep disturbance but not less physical activity. Class stigma was not associated with health behaviors after full adjustment for weight/racial discrimination and psychological factors. Results from this investigation suggest that beyond one's objective SES, the stigma associated with having low class may also contribute to poorer health behaviors.
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Affiliation(s)
- David G Figueroa
- Department of Psychology, University of California Los Angeles, Los Angeles, CA, USA
| | - Jordan E Parker
- Department of Psychology, University of California Los Angeles, Los Angeles, CA, USA
| | | | | | - Keely A Muscatell
- Department of Psychology & Neuroscience, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - A Janet Tomiyama
- Department of Psychology, University of California Los Angeles, Los Angeles, CA, USA.
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Foster T, Eaton M, Probst Y. The relationship between internalised weight bias and biopsychosocial outcomes in children and youth: a systematic review. J Eat Disord 2024; 12:38. [PMID: 38491402 PMCID: PMC10941429 DOI: 10.1186/s40337-023-00959-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/04/2023] [Accepted: 12/20/2023] [Indexed: 03/18/2024] Open
Abstract
OBJECTIVE To synthesise the evidence on the relationships between internalised weight bias (IWB) and biopsychosocial health outcomes in individuals ≤ 25 years. METHODS A systematic review was conducted by searching five scientific databases up to May 2022 to retrieve studies that investigated associations between IWB and biopsychosocial outcomes. Articles with participants ≤ 25 years, at least one validated measure of IWB, one measure of a biopsychosocial outcome, and were observational were included. Excluded articles involved systematic literature reviews, case study reports, intervention studies, meta-analyses, grey literature, pilot, and feasibility studies. Quality assessment was carried out using the American Dietetic Association Quality Criteria Checklist. The protocol was registered with PROSPERO, ID number CRD42022323876. RESULTS Two hundred and sixty-six articles were identified. Nineteen were eligible for inclusion, (15 cross-sectional and 4 prospective). The Weight Bias Internalization Scale and the Weight Self-Stigma Questionnaire were the most used tools to assess IWB with large heterogeneity in tool types used to assess biopsychosocial measures. IWB had positive associations with psychopathology, eating disorder symptomology, higher BMI, being female, and experiences of weight stigma. It was negatively associated with quality of life, body image, physical activity, social ability, self-esteem, and socioeconomic status. DISCUSSION IWB associated with adverse biopsychosocial outcomes in children and youth populations. IWB may be more clinically relevant in assessing at-risk children and youth than physical weight due to its psychosocial aspects and ability to expand beyond the scope of BMI. Research would benefit from better assessment tools designed for children and youth that accurately measure IWB. Future research should focus on increased diversity and longitudinal study designs with children and youth-specific populations.
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Affiliation(s)
- Tiarna Foster
- School of Medical, Indigenous and Health Sciences, University of Wollongong, Wollongong, NSW, Australia
| | - Melissa Eaton
- School of Medical, Indigenous and Health Sciences, University of Wollongong, Wollongong, NSW, Australia
| | - Yasmine Probst
- School of Medical, Indigenous and Health Sciences, University of Wollongong, Wollongong, NSW, Australia.
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8
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Bidstrup H, Brennan L, Kaufmann L, Meadows A, de la Piedad Garcia X. A systematic review of ecological momentary assessment studies on weight stigma and a call for a large-scale collaboration. Obes Rev 2024; 25:e13676. [PMID: 38115555 DOI: 10.1111/obr.13676] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/14/2022] [Revised: 09/21/2023] [Accepted: 11/13/2023] [Indexed: 12/21/2023]
Abstract
BACKGROUND Weight stigma is associated with poor mental health correlates in cross-sectional research. Researchers are increasingly using Ecological Momentary Assessment (EMA) methods, collecting comprehensive within-person data to understand the temporal nature of weight stigma and its biopsychosocial correlates. AIM To systematically review EMA studies on the effect of weight stigma on biopsychosocial correlates and integrate the findings. METHOD PsycINFO, CINAHL, Embase, Medline Complete, and Web of Science were searched and studies were doubled screened (H.B. and X.P.G.). RESULTS Twelve studies (N = 615) met our inclusion criteria. For both between- and within-subject effects, experienced and internalized weight stigmas were associated with negative correlates/outcomes (e.g., higher disordered eating and lower positive mood). However, studies differed in the correlate measures assessed, EMA methods used, and participant instructions provided. Given these inconsistencies, comparison across studies was difficult, and findings could not be reliably integrated. CONCLUSIONS Consistent with previous research, studies from this review suggest weight stigma leads to adverse outcomes. EMA has the potential to overcome many of the limitations present in cross-sectional research on weight stigma and provide more ecologically valid and reliable results. We argue for a collaborative data-sharing consortium with standardized EMA methodologies, so researchers worldwide can contribute to and make use of a large, collective dataset on weight stigma and health correlates (see osf.io/s5ru6/).
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Affiliation(s)
- Hugh Bidstrup
- School of Behavioural and Health Sciences, Australian Catholic University, Fitzroy, Victoria, Australia
- School of Psychology and Public Health, La Trobe University, Albury/Wodonga, Victoria, Australia
| | - Leah Brennan
- School of Psychology and Public Health, La Trobe University, Albury/Wodonga, Victoria, Australia
- Centre for Eating, Weight, and Body Image, East Melbourne, Victoria, Australia
| | - Leah Kaufmann
- School of Behavioural and Health Sciences, Australian Catholic University, Fitzroy, Victoria, Australia
| | - Angela Meadows
- Department of Psychology, University of Essex, Colchester, UK
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9
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Wang C, Hunger JM, Liao J, Figueroa D, Lopez A, Tomiyama AJ. Examining the effect of weight-related recruitment information on participant characteristics: A randomized field experiment. Obes Sci Pract 2024; 10:e739. [PMID: 38313600 PMCID: PMC10835742 DOI: 10.1002/osp4.739] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2023] [Revised: 12/14/2023] [Accepted: 01/14/2024] [Indexed: 02/06/2024] Open
Abstract
Objective Although 82% of American adults have a body mass index (BMI) of over 25, individuals with elevated BMI are considered difficult to recruit for studies. Effective participant identification and recruitment are crucial to minimize the likelihood of sampling bias. One understudied factor that could lead to sampling bias is the study information presented in recruitment materials. In the context of weight research, potential participants with higher weight may avoid studies that advertise weight-related procedures. Thus, this study experimentally manipulated the phrasing of weight-related information included in recruitment materials and examined its impact on participants' characteristics. Methods Two visually similar flyers, either weight-salient or neutral, were randomly posted throughout a university campus to recruit participants (N = 300) for a short survey, assessing their internalized weight bias, anticipated and experienced stigmatizing experiences, eating habits, and general demographic characteristics. Results Although the weight-salient (vs. neutral) flyer took 18.5 days longer to recruit the target sample size, there were no between flyer differences in respondents' internalized weight bias, anticipated/experienced weight stigma, disordered eating behaviors, BMI, or perceived weight. Absolute levels of these variables, however, were low overall. Conclusion Providing detailed information about study procedures allows participants to have more autonomy over their participation without differentially affecting participant characteristics.
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Affiliation(s)
- Christy Wang
- Department of Psychology University of California Los Angeles California USA
| | | | - Joseph Liao
- Department of Psychology University of California Los Angeles California USA
| | - David Figueroa
- Department of Psychology University of California Los Angeles California USA
| | - Alejandra Lopez
- Department of Psychology University of California Los Angeles California USA
| | - A Janet Tomiyama
- Department of Psychology University of California Los Angeles California USA
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10
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Sonneville KR, Thurston IB, Gordon AR, Richmond TK, Weeks HM, Lipson SK. Weight Stigma Associated With Mental Health Concerns Among College Students. Am J Prev Med 2024; 66:260-268. [PMID: 37758003 DOI: 10.1016/j.amepre.2023.09.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/26/2023] [Revised: 09/21/2023] [Accepted: 09/21/2023] [Indexed: 09/29/2023]
Abstract
INTRODUCTION Weight stigma is widespread and exists across numerous domains including health care, educational institutions, workplaces, mass media, and interpersonal relationships. Weight stigma experienced during the college years may be particularly consequential because the college years are a period of increased vulnerability for the development of mental health concerns. The purpose of the present study was to examine how experiences of weight stigma relate to mental health concerns, including symptoms of eating disorders, anxiety, and depression, among college students. METHODS Prevalence of interpersonal and anticipated weight stigma was examined among 2,707 students participating in the 2018-2019 and 2019-2020 Healthy Minds Study and tested for differences in prevalence across student characteristics. Logistic regression was used to explore relationships between measures of weight stigma and student mental health. Analyses were conducted in 2021-2023. RESULTS Interpersonal and anticipated weight stigma were reported by 12.3% and 15.3% of students, respectively. Experiences of interpersonal and anticipated weight stigma were generally lowest among cisgender male students, heterosexual students, those with the fewest financial concerns, and those who did not perceive themselves to be "overweight." Both interpersonal and anticipated weight stigma were associated with elevated odds of high weight concerns, past-month binge eating, past-month purging, high eating disorder risk, moderate/severe anxiety symptoms, and moderate/severe depressive symptoms. CONCLUSIONS Findings implicate interpersonal and anticipated weight stigma as potential risk factors for a range of mental health concerns. Weight stigma is an under-recognized and under-funded public health problem.
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Affiliation(s)
- Kendrin R Sonneville
- Department of Nutritional Sciences, University of Michigan School of Public Health, Ann Arbor, Michigan.
| | - Idia B Thurston
- Departments of Health Sciences and Applied Psychology, Institute for Health Equity and Social Justice Research, Northeastern University, Boston, Massachusetts
| | - Allegra R Gordon
- Department of Community Health Sciences, Boston University School of Public Health, Boston, Massachusetts
| | - Tracy K Richmond
- Division of Adolescent/Young Adult Medicine, Department of Pediatrics, Harvard Medical School, Boston Children's Hospital, Boston, Massachusetts
| | - Heidi M Weeks
- Department of Nutritional Sciences, University of Michigan School of Public Health, Ann Arbor, Michigan
| | - Sarah K Lipson
- Department of Health Law Policy and Management, Boston University School of Public Health, Boston, Massachusetts
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Anguah KOB, Christ SE. Exposure to written content eliciting weight stigmatization: Neural responses in appetitive and food reward regions. Obesity (Silver Spring) 2024; 32:80-90. [PMID: 37861062 DOI: 10.1002/oby.23917] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/08/2023] [Revised: 07/28/2023] [Accepted: 08/19/2023] [Indexed: 10/21/2023]
Abstract
OBJECTIVE Neural activity in food reward- and appetite-related regions was examined in response to high-calorie (HC), low-calorie, and non-food pictures after exposure to written weight stigma (WS) content. Relationships with eating behavior (by Three-Factor Eating Questionnaire [TFEQ]), blood glucose, and subjective appetite were also explored. METHODS Adults with overweight and obesity were randomized to read either a WS (n = 20) or control (n = 20) article and subsequently underwent brain scans while they rated pleasantness of food pictures. Fasting glucose, TFEQ, stigma experiences, and appetite were measured before reading the article, appetite after reading, and glucose and appetite again after the scan. RESULTS A priori region of interest analyses revealed significant group differences in activation to HC > low-calorie food cues in the caudate and thalamus whereas exploratory whole-brain analyses suggested significant differences in regions including left insula, left thalamus, left inferior temporal gyrus, right lingual gyrus, and bilateral middle occipital gyrus and superior parietal lobule (p < 0.005 uncorrected, k ≥ 200 m3 ). No significant relationships were observed between the pattern of activation and TFEQ, glucose, or subjective appetite in the WS group. CONCLUSIONS Exposure to WS was associated with increased responsiveness to HC food content in the dorsal striatum and thalamus in individuals with overweight and obesity.
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Affiliation(s)
- Katherene O B Anguah
- Department of Nutrition and Exercise Physiology, University of Missouri, Columbia, Missouri, USA
| | - Shawn E Christ
- Department of Psychological Sciences, University of Missouri, Columbia, Missouri, USA
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12
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Fitterman-Harris HF, Davis GG, Bedard SP, Cusack CE, Levinson CA. Digital Mental Health Interventions: Differences in Diet Culture Intervention Framing. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 21:24. [PMID: 38248489 PMCID: PMC10815398 DOI: 10.3390/ijerph21010024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/10/2023] [Revised: 12/14/2023] [Accepted: 12/20/2023] [Indexed: 01/23/2024]
Abstract
Diet culture is a societal norm that ranks thin bodies as superior to other body types and has been associated with negative outcomes, such as eating disorders. Wellness has evolved into a term that is often used to promote diet culture messages. One possible way to combat diet culture is through single-session, digital mental health interventions (DMHIs), which allow for increased access to brief public health treatments. The framing of DMHIs is critical to ensure that the target population is reached. Participants (N = 397) were enrolled in a single-session DMHI, which was framed as either a Diet Culture Intervention (n = 201) or a Wellness Resource (n = 196). Baseline group differences in eating disorder pathology, body image, weight stigma concerns, fat acceptance, and demographic characteristics were analyzed. Across groups, participants reported moderately high eating disorder pathology, low-to-moderate levels of body dissatisfaction, moderate levels of fat acceptance, and either very low or very high weight stigma concerns. Participants in the Diet Culture Intervention group reported higher levels of fat acceptance than those in the Wellness Resource group (p < 0.001). No other framing group differences were identified, though post hoc analyses revealed differences based on recruitment source (i.e., social media versus undergraduate research portal). This study found that framing a DMHI as targeting diet culture or as a Wellness Resource can result in the successful recruitment of individuals at risk of disordered eating. Framing a DMHI as a Wellness Resource may increase recruitment of individuals with low levels of fat acceptance, which may be particularly important for dismantling diet culture, disordered eating, and weight stigma concerns. Future research should assess DMHI framing in other populations, such as men and adolescents.
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Affiliation(s)
- Hannah F. Fitterman-Harris
- Department of Psychological and Brain Sciences, University of Louisville, Louisville, KY 40292, USA; (S.P.B.); (C.E.C.); (C.A.L.)
| | - Gabrielle G. Davis
- College of Education and Human Development, University of Louisville, Louisville, KY 40292, USA;
| | - Samantha P. Bedard
- Department of Psychological and Brain Sciences, University of Louisville, Louisville, KY 40292, USA; (S.P.B.); (C.E.C.); (C.A.L.)
- Department of Psychology, University of Wyoming, Laramie, WY 82071, USA
| | - Claire E. Cusack
- Department of Psychological and Brain Sciences, University of Louisville, Louisville, KY 40292, USA; (S.P.B.); (C.E.C.); (C.A.L.)
| | - Cheri A. Levinson
- Department of Psychological and Brain Sciences, University of Louisville, Louisville, KY 40292, USA; (S.P.B.); (C.E.C.); (C.A.L.)
- Department of Pediatrics, Division of Child and Adolescent Psychiatry and Psychology, University of Louisville, Louisville, KY 40292, USA
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13
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Basinger ED, Quinlan MM, Rawlings M. Memorable Messages About Fat Bodies Before, During, and After Pregnancy. HEALTH COMMUNICATION 2023; 38:3069-3079. [PMID: 36199193 DOI: 10.1080/10410236.2022.2131982] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
Weight bias is prevalent for people in large bodies who are trying to conceive, pregnant, or postpartum. Using the theory of memorable messages as a framework, we explored the sources, valence, and content of messages that fat individuals (N = 237) recalled about their bodies before pregnancy through the postpartum stage. The most common source of memorable messages was healthcare providers, and most (77.2%) messages were negatively valenced. Thematic analysis revealed four overarching themes (fat mothers are bad mothers, denial of competent treatment, weight-normative commentary on fat bodies, and weight-inclusive counter-narratives). Our findings illuminate the significance of patient-practitioner communication across the pregnancy trajectory and highlight how counter-narratives can disrupt negative messages about fat pregnancy.
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Affiliation(s)
- Erin D Basinger
- Department of Communication Studies, University of North Carolina at Charlotte
| | - Margaret M Quinlan
- Department of Communication Studies, University of North Carolina at Charlotte
| | - Margaret Rawlings
- Department of Communication Studies, University of North Carolina at Charlotte
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Lin YC, Lin CY, Saffari M, Tsai MC, Chang YH, Strong C, Chen JK, Hsieh YP, Yang YN, Latner JD. Weight stigma is associated with body mass index among college students in Taiwan: the mediated role of internalized weight stigma. BMC Psychol 2023; 11:365. [PMID: 37915074 PMCID: PMC10621093 DOI: 10.1186/s40359-023-01414-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2023] [Accepted: 10/26/2023] [Indexed: 11/03/2023] Open
Abstract
BACKGROUND Weight stigma is an issue often studied in Western countries; however, such information is scarce in Asian studies. METHODS This study aimed to examine the role of internalized weight stigma as a mediator in the relationship between perceived weight stigma and changes in body mass index (BMI). The data were collected through a longitudinal online survey with two phases (n = 974; Phase 1: August and September 2021; Phase 2: November and December 2021). The Perceived Weight Stigma Scale (PWSS), Weight Self-Stigma Questionnaire (WSSQ), and Depression, Anxiety, Stress Scale - 21 (DASS-21) were administered to assess perceived weight stigma, internalized weight stigma, and psychological distress. Hierarchical regressions were used to examine the proposed model, and Hayes' Process Macro was used to test a mediation model. RESULTS The changes in perceived weight stigma and internalized weight stigma were significantly and positively associated with changes in BMI. There were significant and positive associations between perceived weight stigma, internalized weight stigma and psychological distress over time. Change in internalized weight stigma was found to be a significant mediator in the association of change in perceived weight stigma with change in BMI for the entire sample (unstandardized coefficient = 0.04; 95% CI = 0.02, 0.06), female subgroup (unstandardized coefficient = 0.05; 95% CI = 0.02, 0.08), and male subgroup (unstandardized coefficient = 0.03; 95% CI = 0.01, 0.06). Change in perceived weight stigma also had significant effects on change in BMI for the entire sample and the female subgroup, but not for the male subgroup. CONCLUSION Because perceived weight stigma may significantly impact changes in BMI through internalized weight stigma, treatment strategies to ameliorate self-stigma may enhance the results of weight-reduction programs. Such treatment strategies should be considered for inclusion in weight-loss interventions.
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Affiliation(s)
- Yi-Ching Lin
- Department of Early Childhood and Family Education, National Taipei University of Education, Taipei, 106320, Taiwan
| | - Chung-Ying Lin
- Institute of Allied Health Sciences, College of Medicine, National Cheng Kung University, 1 University Rd, Tainan, 701, Taiwan.
- University of Religions and Denominations, Qom, Iran.
- Department of Public Health, College of Medicine, National Cheng Kung University, Tainan, Taiwan.
- Biostatistics Consulting Center, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan.
| | - Mohsen Saffari
- Health Research Center, Life Style Institute, Baqiyatallah University of Medical Sciences, Tehran, Iran
- Health Education Department, Faculty of Health, Baqiyatallah University of Medical Sciences, Tehran, Iran
| | - Meng-Che Tsai
- Department of Pediatrics, College of Medicine, National Cheng Kung University Hospital, National Cheng Kung University, Tainan, Taiwan
- Department of Medical Humanities and Social Medicine, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Yun-Hsuan Chang
- Institute of Gerontology, College of Medicine, National Cheng Kung University, Tainan, Taiwan
- Department of Psychology, National Cheng Kung University, Tainan, Taiwan
| | - Carol Strong
- Department of Public Health, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Ji-Kang Chen
- Department of Social Work, Chinese University of Hong Kong, New Territories, Hong Kong, China
| | - Yi-Ping Hsieh
- Department of Social Work, College of Nursing and Professional Disciplines, University of North Dakota, Grand Forks, ND, USA
| | - Yung-Ning Yang
- Department of Pediatrics, E-DA Hospital, I-Shou University, Kaohsiung, Taiwan.
- School of Medicine, I-Shou University, Kaohsiung, Taiwan.
| | - Janet D Latner
- Department of Psychology, University of Hawaii at Manoa, Honolulu, HI, USA
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Byanyima JI, Li X, Vesslee SA, Kranzler HR, Shi Z, Wiers CE. Metabolic profiles associated with opioid use and opioid use disorder: a narrative review of the literature. CURRENT ADDICTION REPORTS 2023; 10:581-593. [PMID: 37982033 PMCID: PMC10656052 DOI: 10.1007/s40429-023-00493-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/02/2023] [Indexed: 11/21/2023]
Abstract
Purpose of Review Opioid use disorder (OUD) is a chronic, relapsing condition that is epidemic in the USA. OUD is associated with serious adverse consequences, including higher incarceration rates, impaired medical and mental health, and overdose-related fatalities. Several medications with demonstrated clinical efficacy in reducing opioid use are approved to treat OUD. However, there is evidence that medications for OUD cause metabolic impairments, which raises concerns over the long-term metabolic health of individuals recovering from OUD. Here, we summarize the scientific literature on the metabolic effects of the use of opioids, including medications for treating OUD. Recent Findings Our findings showed lower body weight and adiposity, and better lipid profiles in individuals with OUD. In individuals with diabetes mellitus, opioid use was associated with lower blood glucose levels. In contrast, among individuals without underlying metabolic conditions, opioids promoted insulin resistance. Treatment of OUD patients with the agonists methadone or buprenorphine caused weight gain, increased liking and intake of sugar, and impaired lipid profile and glucose metabolism, whereas treatment with the antagonist naltrexone demonstrated evidence for reduced sweet preferences. Summary Our findings highlighted a gap in knowledge regarding the safety of medications for OUD. Further research is needed to determine how best to reduce the risk of metabolic disorder in the treatment of OUD with opioid agonists versus antagonists.
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Affiliation(s)
- Juliana I Byanyima
- Center for Studies of Addiction, Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, 3535 Market St. Suite 500, Philadelphia, PA 191904, USA
| | - Xinyi Li
- Center for Studies of Addiction, Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, 3535 Market St. Suite 500, Philadelphia, PA 191904, USA
| | - Sianneh A Vesslee
- Center for Studies of Addiction, Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, 3535 Market St. Suite 500, Philadelphia, PA 191904, USA
| | - Henry R Kranzler
- Center for Studies of Addiction, Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, 3535 Market St. Suite 500, Philadelphia, PA 191904, USA
| | - Zhenhao Shi
- Center for Studies of Addiction, Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, 3535 Market St. Suite 500, Philadelphia, PA 191904, USA
| | - Corinde E Wiers
- Center for Studies of Addiction, Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, 3535 Market St. Suite 500, Philadelphia, PA 191904, USA
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Sharp M, Ward L, Solar C, Shea C, Carels RA, Dolbier C. Internalized Weight Bias, Weight-Related Experiences, And Peripartum Weight. J Midwifery Womens Health 2023; 68:490-498. [PMID: 36912269 PMCID: PMC10497705 DOI: 10.1111/jmwh.13480] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2022] [Revised: 01/13/2023] [Accepted: 01/17/2023] [Indexed: 03/14/2023]
Abstract
INTRODUCTION The purpose of this study was to investigate internalized weight bias (IWB) and its relationship with pregnancy-related weight changes and postpartum depression. IWB is defined as the internalization of negative attitudes and beliefs about people due to their weight. Although IWB has been linked with weight change and depression in other samples, it has never been investigated in the postpartum period. METHODS We used a cross-sectional survey design. Participants were 251 women recruited via social media who were living in the United States and 6 to 12 months postpartum. We calculated percentage of body weight gained during pregnancy and percentage of that weight that was retained postpartum from self-reported weights. Participants completed self-report measures of IWB (modified version of the Weight Bias Internalization Scale) and postpartum depression (Edinburgh Postnatal Depression Scale). RESULTS Gestational weight gain was not significantly associated with IWB or depression. Postpartum retention of gestational weight was significantly positively associated with both IWB and depressive symptoms. Furthermore, IWB mediated the relationship between postpartum weight retention and depressive symptoms. DISCUSSION Postpartum retention of weight gained during pregnancy, but not weight gain itself, was related to both IWB and depressive symptoms. The relationship between pregnancy-related weight changes and psychological distress is complex. Sociocultural pressures to return to a prepregnancy physical state swiftly after giving birth may increase risk for IWB during a time in life when stress is already likely to be high, posing additional psychological risk. IWB existing prepregnancy may also worsen postpartum self-concept, contributing to depression. This is the first study, to our knowledge, to directly assess associations among gestational weight change, IWB, and postpartum depression. In addition to discussing weight in pregnancy, perinatal care providers could improve postpartum health by helping women set realistic, body-positive goals postpartum.
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Affiliation(s)
- Meghan Sharp
- Department of Psychiatry and Human Behavior, Warren Alpert Medical School of Brown University, Providence, Rhode Island
- Women’s Medicine Collaborative, The Miriam Hospital, Providence, Rhode Island
| | - L.G. Ward
- Department of Psychiatry and Human Behavior, Warren Alpert Medical School of Brown University, Providence, Rhode Island
- Women’s Medicine Collaborative, The Miriam Hospital, Providence, Rhode Island
- Centers for Behavioral & Preventative Medicine, The Miriam Hospital, Providence, Rhode Island
| | | | - Chelsea Shea
- Lifespan Obstetrics and Gynecology, Providence, Rhode Island
| | - Robert A. Carels
- Department of Psychology, East Carolina University, Greenville, North Carolina
| | - Christyn Dolbier
- Department of Psychology, East Carolina University, Greenville, North Carolina
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Fekih-Romdhane F, He J, Malaeb D, Dabbous M, Hallit R, Obeid S, Hallit S. Psychometric properties of the Arabic versions of the Three-Item Short Form of the modified Weight Bias Internalization Scale (WBIS-3) and the Muscularity Bias Internalization Scale (MBIS). J Eat Disord 2023; 11:82. [PMID: 37221616 DOI: 10.1186/s40337-023-00805-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2023] [Accepted: 05/11/2023] [Indexed: 05/25/2023] Open
Abstract
BACKGROUND There is a lack of psychometrically sound measures to assess internalized weight and muscularity biases among Arabic-speaking people. To fill this gap, we sought to investigate the psychometric properties of Arabic translations of the Three-Item Short Form of the Modified Weight Bias Internalization Scale (WBIS-3) and the Muscularity Bias Internalization Scale (MBIS) in a sample of community adults. METHODS A total of 402 Lebanese citizens and residents enrolled in this cross-sectional study (mean age: 24.46 years (SD = 6.60); 55.2% females). Exploratory Factor Analysis (EFA) was conducted using the principal-axis factoring and oblimin rotation to estimate parameters and the parallel analysis to determine the number of factors. CFA was conducted using the weighted least square mean and variance adjusted estimator which was recommended for ordinal CFA. RESULTS An Exploratory Factor Analysis of the WBIS-3 resulted in a robust single-factor solution for the three items. An examination of the factorial structure of the MBIS revealed a two-factor structure, which showed adequate model fit. We obtained excellent internal consistency as indicated by McDonald's ω coefficients of .87 for the WBIS-3 total score and ranging between .92 and .95 for the MBIS two factor scores. Cross-sex invariance of the MBIS was confirmed at the configural, metric, and scalar levels. Convergent validity was supported by significant correlations between the WBIS-3 and MBIS. Divergent and concurrent validity were approved by showing small to medium correlations between MBIS/WBIS-3 scores and muscle dysmorphia, disordered eating symptoms, and body image concerns. CONCLUSION Findings suggest that the Arabic versions of the WBIS-3 and MBIS are suitable for use in Arabic-speaking adults.
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Affiliation(s)
- Feten Fekih-Romdhane
- The Tunisian Center of Early Intervention in Psychosis, Department of Psychiatry "Ibn Omrane", Razi Hospital, Manouba City, Tunisia
- Faculty of Medicine of Tunis, Tunis El Manar University, Tunis, Tunisia
| | - Jinbo He
- School of Humanities and Social Science, The Chinese University of Hong Kong, Shenzhen, 518172, Guangdong, China
| | - Diana Malaeb
- College of Pharmacy, Medical Gulf University, Ajman, United Arab Emirates
- School of Pharmacy, Lebanese International University, Beirut, Lebanon
| | - Mariam Dabbous
- School of Pharmacy, Lebanese International University, Beirut, Lebanon
| | - Rabih Hallit
- School of Medicine and Medical Sciences, Holy Spirit University of Kaslik, Jounieh, Lebanon
- Department of Infectious Disease, Bellevue Medical Center, Mansourieh, Lebanon
- Department of Infectious Disease, Notre Dame des Secours University Hospital, Postal Code 3, Byblos, Lebanon
| | - Sahar Obeid
- Social and Education Sciences Department, School of Arts and Sciences, Lebanese American University, Jbeil, Lebanon.
| | - Souheil Hallit
- School of Medicine and Medical Sciences, Holy Spirit University of Kaslik, Jounieh, Lebanon.
- Psychology Department, College of Humanities, Effat University, Jeddah, 21478, Saudi Arabia.
- Applied Science Research Center, Applied Science Private University, Amman, Jordan.
- Research Department, Psychiatric Hospital of the Cross, Jal Eddib, Lebanon.
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18
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Vilugrón Aravena F, Cortés M, Valenzuela J, Rojas C, Gutiérrez P. [Obesity, weight-related stigma and its association with the perception of quality of life in Chilean university students]. NUTR HOSP 2023. [PMID: 37073745 DOI: 10.20960/nh.04338] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/20/2023] Open
Abstract
INTRODUCTION little attention has been paid to the effect of exposure to weight-related stigma on the quality of life of young Chileans with little obesity. OBJECTIVE to identify the prevalence of weight-related stigma and to analyze its association with obesity and the perception of quality of life in university students from Valparaíso, Chile. METHODS correlational type study and cross-sectional design. Two hundred and sixty-two university students participated, from 18 to 29 years old, matriculated in the Faculty of Health Sciences of a public university in Valparaíso, Chile. Quality of life was assessed with the WHOQOL-BREF scale, weight-related stigma with the Brief Stigmatizing Situations Inventory (SSI), and nutritional status with body mass index (BMI) classification. The application of the questionnaires was on-line and the answers were anonymous. Multiple logistic regression models were used to evaluate the association between the variables, adjusted for gender and age. RESULTS the prevalence of stigma related to weight was 13,2 % in eutrophic, 24,4 % in overweight and 68,0 % in obese. Weight-related stigma, rather than obesity itself, is associated with poorer perceived physical health (OR: 4.30; 95 % CI: 2.10-8.80), psychological health (OR: 4.51; 95 % CI: 2.20-9.26), social relationships (OR: 3.21; 95 % CI: 1.56-6.60) and environment (OR: 2.86; 95 % CI: 1.33-6.14). CONCLUSION students exposed to stigmatizing situations related to weight had a worse perception of their quality of life compared to those not stigmatized.
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Affiliation(s)
- Fabiola Vilugrón Aravena
- Departamento de Salud, Comunidad y Gestión. Facultad de Ciencias de la Salud. Universidad de Playa Ancha
| | - Milenko Cortés
- Nutrición y Dietética. Facultad de Ciencias de la Salud. Universidad de Playa Ancha
| | - Javiera Valenzuela
- Nutrición y Dietética. Facultad de Ciencias de la Salud. Universidad de Playa Ancha
| | - Camila Rojas
- Nutrición y Dietética. Facultad de Ciencias de la Salud. Universidad de Playa Ancha
| | - Paulina Gutiérrez
- Nutrición y Dietética. Facultad de Ciencias de la Salud. Universidad de Playa Ancha
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19
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Feasibility of a Loving Kindness Intervention for Mitigating Weight Stigma in Nursing Students: A Focus on Self-Compassion. Mindfulness (N Y) 2023; 14:841-853. [PMID: 37090853 PMCID: PMC9975442 DOI: 10.1007/s12671-023-02094-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 02/14/2023] [Indexed: 03/05/2023]
Abstract
Objectives Preliminary research on self-compassion as a target for reducing forms of bias is promising, yet healthcare provider self-compassion has not yet been explored in relationship to weight bias. Healthcare providers commonly endorse weight stigma and bias, contributing to health disparities for patients with “obesity.” The current study explores the feasibility of the self-compassion loving kindness meditation (LKM) as a brief intervention that reduces weight bias in nursing students. Method Participants (189 nursing students) were randomly assigned to the LKM condition or body scan control condition before engaging in an implicit bias task and answering self-report measures of internalization of the thin ideal, weight bias, positive attitudes towards people with “obesity,” positive emotions, self-compassion, cognitive flexibility, and compassionate care. Results Statistically significant differences in self-compassion, cognitive flexibility, weight bias, and compassionate care failed to be found between the groups. Participants in the LKM condition endorsed significantly higher levels of positive emotionality compared to the control condition. Higher levels of self-compassion were related to lower levels of weight bias for participants in both conditions. Multiple linear regression analyses revealed that internalization of the thin ideal and self-compassion accounted for 19.2% of the variance in positive attitudes towards people with “obesity.” Conclusions This study suggests the importance of examining self- and other-compassion in the context of weight stigma. Its findings exemplify the complexity of weight stigma and the need to further explore the mechanisms to be targeted to effectively reduce healthcare professionals’ bias. Pre-registration This study is not preregistered.
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20
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O'Loughlin J, Casanova F, Fairhurst-Hunter Z, Hughes A, Bowden J, Watkins ER, Freathy RM, Millwood IY, Lin K, Chen Z, Li L, Lv J, Walters RG, Howe LD, Kuchenbaecker K, Tyrrell J. Mendelian randomisation study of body composition and depression in people of East Asian ancestry highlights potential setting-specific causality. BMC Med 2023; 21:37. [PMID: 36726144 PMCID: PMC9893684 DOI: 10.1186/s12916-023-02735-8] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/18/2022] [Accepted: 01/12/2023] [Indexed: 02/03/2023] Open
Abstract
BACKGROUND Extensive evidence links higher body mass index (BMI) to higher odds of depression in people of European ancestry. However, our understanding of the relationship across different settings and ancestries is limited. Here, we test the relationship between body composition and depression in people of East Asian ancestry. METHODS Multiple Mendelian randomisation (MR) methods were used to test the relationship between (a) BMI and (b) waist-hip ratio (WHR) with depression. Firstly, we performed two-sample MR using genetic summary statistics from a recent genome-wide association study (GWAS) of depression (with 15,771 cases and 178,777 controls) in people of East Asian ancestry. We selected 838 single nucleotide polymorphisms (SNPs) correlated with BMI and 263 SNPs correlated with WHR as genetic instrumental variables to estimate the causal effect of BMI and WHR on depression using the inverse-variance weighted (IVW) method. We repeated these analyses stratifying by home location status: China versus UK or USA. Secondly, we performed one-sample MR in the China Kadoorie Biobank (CKB) in 100,377 participants. This allowed us to test the relationship separately in (a) males and females and (b) urban and rural dwellers. We also examined (c) the linearity of the BMI-depression relationship. RESULTS Both MR analyses provided evidence that higher BMI was associated with lower odds of depression. For example, a genetically-instrumented 1-SD higher BMI in the CKB was associated with lower odds of depressive symptoms [OR: 0.77, 95% CI: 0.63, 0.95]. There was evidence of differences according to place of residence. Using the IVW method, higher BMI was associated with lower odds of depression in people of East Asian ancestry living in China but there was no evidence for an association in people of East Asian ancestry living in the USA or UK. Furthermore, higher genetic BMI was associated with differential effects in urban and rural dwellers within China. CONCLUSIONS This study provides the first MR evidence for an inverse relationship between BMI and depression in people of East Asian ancestry. This contrasts with previous findings in European populations and therefore the public health response to obesity and depression is likely to need to differ based on sociocultural factors for example, ancestry and place of residence. This highlights the importance of setting-specific causality when using genetic causal inference approaches and data from diverse populations to test hypotheses. This is especially important when the relationship tested is not purely biological and may involve sociocultural factors.
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Affiliation(s)
- Jessica O'Loughlin
- Department of Clinical and Biomedical Sciences, Faculty of Health and Life Sciences, University of Exeter, Exeter, UK
| | - Francesco Casanova
- Department of Clinical and Biomedical Sciences, Faculty of Health and Life Sciences, University of Exeter, Exeter, UK
| | - Zammy Fairhurst-Hunter
- Clinical Trial Service Unit and Epidemiological Studies Unit (CTSU), Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Amanda Hughes
- MRC Integrative Epidemiology Unit (IEU), Bristol Medical School, Population Health Sciences, University of Bristol, Bristol, UK
| | - Jack Bowden
- Department of Clinical and Biomedical Sciences, Faculty of Health and Life Sciences, University of Exeter, Exeter, UK
| | | | - Rachel M Freathy
- Department of Clinical and Biomedical Sciences, Faculty of Health and Life Sciences, University of Exeter, Exeter, UK
| | - Iona Y Millwood
- Clinical Trial Service Unit and Epidemiological Studies Unit (CTSU), Nuffield Department of Population Health, University of Oxford, Oxford, UK
- MRC Population Health Research Unit (PHRU), Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Kuang Lin
- Clinical Trial Service Unit and Epidemiological Studies Unit (CTSU), Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Zhengming Chen
- Clinical Trial Service Unit and Epidemiological Studies Unit (CTSU), Nuffield Department of Population Health, University of Oxford, Oxford, UK
- MRC Population Health Research Unit (PHRU), Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Liming Li
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China
| | - Jun Lv
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China
| | - Robin G Walters
- Clinical Trial Service Unit and Epidemiological Studies Unit (CTSU), Nuffield Department of Population Health, University of Oxford, Oxford, UK
- MRC Population Health Research Unit (PHRU), Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Laura D Howe
- MRC Integrative Epidemiology Unit (IEU), Bristol Medical School, Population Health Sciences, University of Bristol, Bristol, UK
| | | | - Jessica Tyrrell
- Department of Clinical and Biomedical Sciences, Faculty of Health and Life Sciences, University of Exeter, Exeter, UK.
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21
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O'Neill EA, Trout K, Ramseyer Winter V. Relationships between experiencing anti-fat microaggressions, body appreciation, and perceived physical and mental health. J Health Psychol 2023; 28:107-118. [PMID: 35699369 DOI: 10.1177/13591053221103421] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
This study examined whether body appreciation mediates the relationships between anti-fat microaggression experiences and perceived physical and mental health. Using a cross-sectional survey design, our study included 384 adult cisgender women in the United States. We found that anti-fat microaggression experiences had a negative association with body appreciation, and perceived physical and mental health. Body appreciation had a positive relationship to perceived physical and mental health. Our study further suggests that body appreciation is an important modifiable factor that mediates the relationships between anti-fat microaggression experiences and perceived mental and physical health. Implications for practice and research are discussed.
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Affiliation(s)
- Elizabeth A O'Neill
- Social Work Department, Washburn University, Topeka, KS, USA.,Center for Body Image Research and Policy, University of Missouri, Columbia, MO, USA
| | - Kate Trout
- School of Health Professions, University of Missouri, Columbia, MO, USA
| | - Virginia Ramseyer Winter
- Center for Body Image Research and Policy, University of Missouri, Columbia, MO, USA.,School of Social Work, University of Missouri, Columbia, MO, USA
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Piri N, Moradi Y, Gheshlagh RG, Abdullahi M, Fattahi E, Moradpour F. Validity of self-reported hypertension and related factors in the adult population: Preliminary results from the cohort in the west of Iran. J Clin Hypertens (Greenwich) 2023; 25:146-157. [PMID: 36625724 PMCID: PMC9903199 DOI: 10.1111/jch.14627] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2022] [Revised: 12/13/2022] [Accepted: 12/13/2022] [Indexed: 01/11/2023]
Abstract
This study aimed to investigate the validity of self-reported hypertension and related factors in the Dehgolan Prospective Cohort Study (DehPCS). Data were obtained from 3996 participants aged 35-70 years in the enrolment phase of DehPCS. Self-reported hypertension and sociodemographic factors were collected by well-trained interviewers before hypertension diagnosis based on the reference criteria. The history of anti-hypertensive medication use and/or systolic blood pressure ≥140 (mmHg), or diastolic blood pressure ≥90 (mmHg) were considered as hypertension. Disagreement between self-reported and reference measures was assessed using sensitivity, specificity, positive, and negative predictive values (PPV and NPV), and kappa values. Binary and multinomial logistic regressions were used to investigate the correlates of validity of self-reported hypertension. The hypertension prevalence based on self-reports and the reference criteria was 19.49% and 21.60%, respectively. An acceptable percentage of kappa agreement value of 68.7% and relatively good overall agreement of 89.8% were found. Self-reported hypertension was guaranteed moderate sensitivity of 72.0% and high specificity of 94.5%, as well as the NPV and PPV of 92/7% and 77/9%, respectively. The chances of false-positive and false-negative reporting increased with older age, higher BMI, and a family history of hypertension. Being female, older age, higher BMI, concurrent diabetes, and stronger family ties to hypertension patients significantly increased the chance of reporting true positives relative to true negatives. Although, self-reported hypertension has an acceptable validity and can be used as a valid tool for screening epidemiological studies, it needs to be investigated because its validity is affected by age, gender, family history of hypertension, and other socio-demographic characteristics.
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Affiliation(s)
- Negar Piri
- Health Network of DehgolanKurdistan University of Medical SciencesSanandajIran
| | - Yousef Moradi
- Department of Epidemiology and BiostatisticsFaculty of MedicineKurdistan University of Medical SciencesSanandajIran
| | - Reza Ghanei Gheshlagh
- Spiritual Health Research CenterResearch Institute for Health DevelopmentKurdistan University of Medical SciencesSanandajIran
| | | | - Eghbal Fattahi
- Department of Internal MedicineTohid HospitalKurdistan University of Medical SciencesSanandajIran
| | - Farhad Moradpour
- Social Determinants of Health Research CenterResearch Institute for Health DevelopmentKurdistan University of Medical SciencesSanandajIran
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23
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Moore MM, Tyra AT, Young DA, Ginty AT. Cardiovascular stress reactivity, habituation, and adiposity. Psychophysiology 2022; 60:e14232. [PMID: 36523148 DOI: 10.1111/psyp.14232] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2022] [Revised: 10/18/2022] [Accepted: 10/27/2022] [Indexed: 12/23/2022]
Abstract
The relationship between adiposity and cardiovascular disease morbidity and mortality is complex. One pathway through which adiposity may influence future health outcomes is by altering how biological systems respond to stress. The current study aimed to examine the association between two metrics of adiposity (body mass index and waist-hip ratio) and two indices of cardiovascular stress responses (reactivity and habituation). A sample of 455 participants (Mean age = 19.47, SD = 1.25 years; BMI = 24.32, SD = 5.04 kg/m2 ; 62% female; 17.9% Hispanic/Latino; 65.2% White, 18.7% Asian, 7.9% Black, 0.2% American Indian/Alaska Native, and 7% other) completed two acute psychosocial stress tasks. Heart rate (HR), systolic blood pressure (SBP) and diastolic blood pressure (DBP) were recorded throughout each stressor. In unadjusted and adjusted models, there were no statistically significant associations between adiposity and HR, SBP, or DBP stress reactivity or habituation. The current data do not support the hypothesis that adiposity influences health by altering cardiovascular responses to acute psychological stress. Results are at odds with prior population-level studies and the single prior study examining adiposity and habituation. At the same time, results are in line with mounting evidence that adiposity itself does not drive poor cardiovascular outcomes seen in people classified as overweight or obese.
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Affiliation(s)
- Melody M. Moore
- Department of Psychology and Neuroscience Baylor University Waco Texas USA
| | - Alexandra T. Tyra
- Department of Psychology and Neuroscience Baylor University Waco Texas USA
| | - Danielle A. Young
- Department of Psychology and Neuroscience Baylor University Waco Texas USA
| | - Annie T. Ginty
- Department of Psychology and Neuroscience Baylor University Waco Texas USA
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Decker KM, Philip SR, Thurston IB. Measuring weight- and shape-based social identity threat vulnerability in young adults. Body Image 2022; 42:136-144. [PMID: 35714420 DOI: 10.1016/j.bodyim.2022.06.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/04/2022] [Revised: 06/03/2022] [Accepted: 06/04/2022] [Indexed: 11/26/2022]
Abstract
This study assessed the factor structure of a novel self-report measure of weight- and shape-based social identity threat vulnerability, Social Identities and Attitudes Scale-Weight and Body Shape (SIAS-WBS). Weight and race diverse young adults (N = 542; Mage=21.69 +2.32; 69% ciswomen) were recruited from Amazon Mechanical Turk and a university participant pool. Exploratory and confirmatory factor analyses, measurement invariance, internal consistency, convergent validity, and test-retest reliability were conducted. The SIAS-WBS had acceptable factor structure with 15 subscales that were invariant across race, ethnicity, gender, weight perception, and CDC-defined weight groups. The measure demonstrated high internal consistency, convergent validity, and good test-retest reliability. Subscales were Weight & Shape Identification (Influence and Centrality), Weight & Shape Stigma Consciousness, six identification and six negative affect factors across the domains of: Social, Familial, Romantic, Intellectual, Physical Activity, and Physical Attractiveness. Participants in higher weight groups who perceived themselves as lower weight status, reported lower Weight & Shape Identification-Influence (p = 0.02) and lower Stigma Consciousness (p = 0.01), relative to those perceiving themselves as higher weight status. Participants perceiving themselves as higher weight status endorsed lower Physical Activity Identification (p < 0.001) and more negative affect across all domains (p's < 0.02). This suggests that weight misperceivers may be less susceptible to weight-based identity threat.
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Affiliation(s)
- Kristina M Decker
- Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA.
| | - Samantha R Philip
- Department of Psychological and Brain Sciences, Texas A&M University, College Station, TX, USA
| | - Idia B Thurston
- Department of Psychological and Brain Sciences, Texas A&M University, College Station, TX, USA; Department of Health Promotion and Community Health Sciences, Texas A&M Health, College Station, TX, USA; Department of Psychology, The University of Memphis, Memphis, TN, USA
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25
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Mazéas A, Chalabaev A, Blond M, Pereira B, Duclos M. Digital intervention promoting physical activity among obese people (DIPPAO) randomised controlled trial: study protocol. BMJ Open 2022; 12:e058015. [PMID: 35710254 PMCID: PMC9204413 DOI: 10.1136/bmjopen-2021-058015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
INTRODUCTION Physical inactivity and excessive sedentary behaviours are major preventable causes in both the development and the treatment of obesity and type 2 diabetes mellitus (T2DM). Nevertheless, current programmes struggle to engage and sustain physical activity (PA) of patients over long periods of time. To overcome these limitations, the Digital Intervention Promoting Physical Activity among Obese people randomised controlled trial (RCT) aims to evaluate the effectiveness of a group-based digital intervention grounded on gamification strategies, enhanced by social features and informed by the tenets of the self-determination theory and the social identity approach. METHODS AND ANALYSIS This trial is a two-arm parallel RCT testing the effectiveness of the Kiplin digital intervention on obese and patients with T2DM in comparison to the usual supervised PA programme of the University Hospital of Clermont-Ferrand, France. A total of 50 patients will be randomised to one of the two interventions and will follow a 3-month programme with a 6-month follow-up postintervention. The primary outcome of the study is the daily step count change between the baseline assessment and the end of the intervention. Accelerometer data, self-reported PA, body composition and physical capacities will also be evaluated. To advance our understanding of complex interventions like gamified and group-based ones, we will explore several psychological mediators relative to motivation, enjoyment, in-group identification or perceived weight stigma. Finally, to assess a potential superior economic efficiency compared with the current treatment, we will conduct a cost-utility analysis between the two conditions. A mixed-model approach will be used to analyse the change in outcomes over time. ETHICS AND DISSEMINATION The research protocol has been reviewed and approved by the Local Human Protection Committee (CPP Ile de France XI, No 21 004-65219). Results will inform the Kiplin app development, be published in scientific journals and disseminated in international conferences. TRIAL REGISTRATION NUMBER NCT04887077.
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Affiliation(s)
- Alexandre Mazéas
- SENS, Univ. Grenoble Alpes, 38000 Grenoble, France
- Department of Human Nutrition, INRAE Centre Clermont-Auvergne-Rhône-Alpes, Clermont-Ferrand, France
- Kiplin, Nantes, France
| | | | | | - Bruno Pereira
- Department of Biostatistics Unit (DRCI), University Hospital Centre, Clermont-Ferrand, France
| | - Martine Duclos
- Department of Human Nutrition, INRAE Centre Clermont-Auvergne-Rhône-Alpes, Clermont-Ferrand, France
- Department of Sport Medicine and Functional Exploration, University Hospital Centre, Clermont-Ferrand, France
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26
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Weight stigma from media: Its associations with coping responses and health outcomes. CURRENT PSYCHOLOGY 2022. [DOI: 10.1007/s12144-022-03179-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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27
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Brown A, Flint SW, Batterham RL. Pervasiveness, impact and implications of weight stigma. EClinicalMedicine 2022; 47:101408. [PMID: 35497065 PMCID: PMC9046114 DOI: 10.1016/j.eclinm.2022.101408] [Citation(s) in RCA: 42] [Impact Index Per Article: 21.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/18/2022] [Revised: 03/21/2022] [Accepted: 04/01/2022] [Indexed: 12/14/2022] Open
Abstract
UNLABELLED Evidence has accumulated to demonstrate the pervasiveness, impact and implications of weight stigma. As such, there is a need for concerted efforts to address weight stigma and discrimination that is evident within, policy, healthcare, media, workplaces, and education. The continuation of weight stigma, which is known to have a negative impact on mental and physical health, threatens the societal values of equality, diversity, and inclusion. This health policy review provides an analysis of the research evidence highlighting the widespread nature of weight stigma, its impact on health policy and the need for action at a policy level. We propose short- and medium-term recommendations to address weight stigma and in doing so, highlight the need change across society to be part of efforts to end weight stigma and discrimination. FUNDING None.
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Affiliation(s)
- Adrian Brown
- UCL Centre for Obesity Research, University College London, London, Greater London, United Kingdom
- Bariatric Centre for Weight Management and Metabolic Surgery, University College London Hospital NHS Trust, London, Greater London, United Kingdom
- National Institute of Health Research, UCLH Biomedical Research Centre, London, Greater London, United Kingdom
| | - Stuart W. Flint
- School of Psychology, University of Leeds, Leeds, West Yorkshire LS2 9JU, United Kingdom
- Scaled Insights, Nexus, University of Leeds, Leeds, West Yorkshire United Kingdom
- Corresponding author at: School of Psychology, University of Leeds, Leeds, West Yorkshire LS2 9JU, United Kingdom.
| | - Rachel L. Batterham
- UCL Centre for Obesity Research, University College London, London, Greater London, United Kingdom
- Bariatric Centre for Weight Management and Metabolic Surgery, University College London Hospital NHS Trust, London, Greater London, United Kingdom
- National Institute of Health Research, UCLH Biomedical Research Centre, London, Greater London, United Kingdom
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Argyrides M, Charalambous Z, Anastasiades E, Michael K. Translation and validation of the Greek version of the Modified Weight Bias Internalization Scale in an adult population. Clin Obes 2022; 12:e12503. [PMID: 34964553 DOI: 10.1111/cob.12503] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/19/2021] [Revised: 11/14/2021] [Accepted: 12/06/2021] [Indexed: 02/02/2023]
Abstract
Weight bias internalization (WBI) has been identified as a global public health concern, which is associated with significant psychological and physical consequences. Despite increased interest in WBI worldwide, cross-cultural research is limited by the lack of availability of validated measures. The aim of the current study was therefore to translate into Greek and validate the Modified Weight Bias Internalization Scale (WBIS-M), the most widely used instrument in the measurement of WBI. An online convenience sample of 642 participants (364 women and 278 men) completed the Greek translation of the WBIS-M and validated the measures of satisfaction with appearance, investment in appearance, weight/appearance anxiety, body appreciation, dysfunctional eating habits and global self-esteem to assess convergent validity. Principal factor and confirmatory analyses revealed that the WBIS-M upheld its one-factor structure. The WBIS-M showed adequate internal consistency, convergent validity and 3-week test-retest reliability. These findings provide support for the cross-cultural equivalence of the WBIS-M and for the utility of this measure in Greek-speaking populations.
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Affiliation(s)
- Marios Argyrides
- Department of Psychology, Neapolis University Pafos, Pafos, Cyprus
| | - Zoe Charalambous
- Department of Psychology, Neapolis University Pafos, Pafos, Cyprus
| | | | - Katerina Michael
- Department of Psychology, Neapolis University Pafos, Pafos, Cyprus
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Austen E, Griffiths S. Weight stigma predicts reduced psychological wellbeing and weight gain among sexual minority men: A 12-month longitudinal cohort study using random intercept cross-lagged panel models. Body Image 2022; 40:19-29. [PMID: 34800860 DOI: 10.1016/j.bodyim.2021.10.006] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/02/2021] [Revised: 08/10/2021] [Accepted: 10/19/2021] [Indexed: 11/27/2022]
Abstract
Weight stigma among sexual minority men predicts negative health outcomes; however, existing research is cross-sectional. Therefore, we longitudinally examined the presence, strength, and direction of relationships between weight stigma and health outcomes in a multi-national cohort of 2953 sexual minority men (Mage = 37.70, SDage = 13.70). Participants reported their Body Mass Index (BMI), experiences of weight discrimination, internalized weight bias, and psychological quality of life at three time-points over 12 months (~August 2019-20). Analyses revealed feedback loops of internalized weight bias with BMI and psychological quality of life: over time, increases in internalized weight bias were associated with small BMI increases (β = 0.07) and small decreases in psychological quality of life (β = 0.12). Reciprocally, increases in BMI and decreases in psychological quality of life were associated with increases in internalized weight bias (βs = 0.18). Experiences of weight discrimination were not longitudinally predictive and were associated with higher BMI (β = 0.29), greater internalized weight bias (β = 0.29), and lower psychological quality of life (β = 0.26) between-persons/cross-sectionally only. Weight stigma is longitudinally and reciprocally associated with reduced psychological wellbeing and weight gain among sexual minority men. Internalized weight bias is a particularly promising intervention target.
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Affiliation(s)
- Emma Austen
- Melbourne School of Psychological Sciences, University of Melbourne, Melbourne, Australia.
| | - Scott Griffiths
- Melbourne School of Psychological Sciences, University of Melbourne, Melbourne, Australia
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30
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Glazer SA, Vallis M. Weight gain, weight management and medical care for individuals living with overweight and obesity during the COVID‐19 pandemic (EPOCH Study). Obes Sci Pract 2022; 8:556-568. [PMID: 36238224 PMCID: PMC9535671 DOI: 10.1002/osp4.591] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2021] [Revised: 12/06/2021] [Accepted: 12/10/2021] [Indexed: 12/04/2022] Open
Abstract
Objective Medical care and weight related experiences have been challenged by the coronavirus disease 2019 (COVID‐19) pandemic for those living with obesity. The magnitude of this impact requires further attention in order to optimize patient care and outcomes. The aim of this study was to assess the impact of the COVID‐19 pandemic and lockdown on access to, and experience of, medical care, weight gain and management strategies, as well as predictors of weight gain. Methods An online survey (June–October 2020) was conducted with two samples; one representative of Canadians living with overweight and obesity (n = 1089) and a second of individuals recruited through obesity clinical services or patient organizations (n = 980). Results Less than half of the total respondents thought that their providers were available for their medical care and most preferred in‐person appointments over telemedicine. Only one quarter were satisfied with their obesity care. Sixty percent of the respondents reported weight gain (on average 5.65 kilograms [kg] gained), with 39.0% gaining more than 5% of their body weight (10.2% gained more than 10%). Over half of the respondents experienced decreased motivation for healthy eating or exercise. One third experienced more frequent and greater food consumption. Although worsening sleep occurred in approximately 20%, there was no significant increase in smoking, alcohol, or cannabis use. Predictors of weight gain were younger patients, higher weight categories, those who struggled with obtaining medical care during the pandemic, as well as those who struggled with eating. Conclusion These results suggest that the COVID‐19 pandemic negatively impacted patient care for those living with overweight and obesity and was associated with weight gain and interfered with weight management strategies. Greater attention to personalized weight management and interventions that focus on the predictors of weight gain should be undertaken.
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Barlev M, Ko A, Krems JA, Neuberg SL. Weight Location Moderates Weight-Based Self-Devaluation and Perceived Social Devaluation in Women. SOCIAL PSYCHOLOGICAL AND PERSONALITY SCIENCE 2022. [DOI: 10.1177/19485506211060724] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Overweight and obese (“heavyweight”) people devalue themselves because, it has been proposed, they are socially devalued. However, for women, social valuation depends not only on how much weight they carry but also on where on their bodies they carry it. Here, we investigated whether weight-based self-valuation and perceived social valuation similarly depend on body shape. Study 1, using a nationally representative sample from National Health and Nutrition Examination Survey (NHANES; N = 1,093 reproductive-aged women), showed that, controlling for body fat, weight labeling (by self and others) and wanting to lose weight depended on body shape. Study 2, in a direct test of predictions using an undergraduate sample of women ( N = 215), showed that with increased body fat, women with an abdominal weight distribution reported more self-devaluation (e.g., lower self-esteem) and perceived social devaluation (e.g., higher perceived weight discrimination); women with a gluteofemoral weight distribution, however, were shielded—partially or fully—from these adverse effects of increased body fat.
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Affiliation(s)
| | - Ahra Ko
- Arizona State University, Tempe, USA
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32
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Internalised weight stigma as a mediator of the relationship between experienced/perceived weight stigma and biopsychosocial outcomes: a systematic review. Int J Obes (Lond) 2022; 46:1-9. [PMID: 34628466 PMCID: PMC8501332 DOI: 10.1038/s41366-021-00982-4] [Citation(s) in RCA: 41] [Impact Index Per Article: 20.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/14/2021] [Revised: 09/14/2021] [Accepted: 09/29/2021] [Indexed: 02/07/2023]
Abstract
OBJECTIVE To systematically review studies that have assessed the mediating role of internalised weight stigma on the relationship between experienced/perceived weight stigma and any biopsychosocial outcomes. METHODS PsycINFO, PsycExtra, Web of Science, CINAHL, Medline and Embase were systematically searched. Identified studies were double screened (HB and XPG). RESULTS Seventeen studies (across 16 articles) met our inclusion criteria (N = 21,172), and almost all studies measured only psychological outcomes (n = 15). Eight studies found consistent evidence for internalised weight stigma as a mediator of the relationship between experienced/perceived weight stigma and disordered eating outcomes. Preliminary evidence was found for the mediating role of internalised weight stigma on the relationship between experienced/perceived weight stigma and body shame, body dissatisfaction, exercise behaviour, healthcare experiences and behaviours, bodily pain and parental weight talk. However, the findings were inconsistent for depression and anxiety, although only two studies reported these. CONCLUSION This review provides preliminary evidence for internalised weight stigma as an intervening variable in the relationship between experienced/perceived weight stigma and adverse health outcomes. Results suggest that there are potential benefits of interventions addressing internalised weight stigma to improve health outcomes. However, these findings must be considered in the context of the psychometric limitations of the Weight Bias Internalisation Scale, which was used in all but one study.
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Nagpal TS, Tomiyama AJ, Incollingo Rodriguez AC. Beyond BMI: Pregnancy-related weight stigma increases risk of gestational diabetes. Prim Care Diabetes 2021; 15:1107-1109. [PMID: 34275770 DOI: 10.1016/j.pcd.2021.07.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/03/2021] [Revised: 07/07/2021] [Accepted: 07/08/2021] [Indexed: 12/11/2022]
Abstract
The objective of this research brief was to assess if prenatal weight stigma is a predictive factor for perinatal complications compared to pre-pregnancy body mass index (BMI). Data were assessed from 358 women. Results indicated weight stigma concerns increased the odds of gestational diabetes, with a stronger association than BMI.
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Affiliation(s)
- Taniya S Nagpal
- Department of Kinesiology, Brock University, St. Catharines, Ontario, Canada
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34
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Kamolthip R, Fung XCC, Lin CY, Latner JD, O'Brien KS. Relationships among Physical Activity, Health-Related Quality of Life, and Weight Stigma in Children in Hong Kong. Am J Health Behav 2021; 45:828-842. [PMID: 34702430 DOI: 10.5993/ajhb.45.5.3] [Citation(s) in RCA: 26] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Objectives: Our objective in this study was to establish the relationships among active and inactive physical activity, HRQoL, and weight stigma in children. Additionally, we investigated weight stigma as a mediator of the relationship between physical activity and HRQoL.Methods: This cross-sectional study was conducted in Hong Kong (June 2017-July 2018). Participants were 437 children in elementary school (2 primary schools and 2 non-governmental organizations) and their parents (dyads). Participants completed questionnaires containing items assessing demographic characteristics, physical activity level, and several HRQoL measures.Results: We found a statistically significant difference between a higher physically activity group (exercise > 2 hours/week) in all measures of HRQoL. Weight stigma had a significant mediating effect on the relationship between physical activity and child-rated HRQoL (Coefficient = -0.37; SE=0.05; t = 8.21; p < .001), parent-rated HRQoL (Coefficient = -0.16; SE = 0.04; t = 4.21; p < .001), and child-rated weight-related QoL (Coefficient = -0.56; SE = 0.04; t = 14.92; p < .001). Conclusions: Physical activity was associated with better HRQoL and lower weight stigma. Weight stigma appears to affect how physical activity is related to better HRQoL, but the association is somewhat weak.
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Affiliation(s)
- Ruckwongpatr Kamolthip
- Ruckwongpatr Kamolthip, Institute of Allied Health Sciences, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Xavier C. C. Fung
- Xavier C. C. Fung, Department of Rehabilitation Sciences, Faculty of Health and Social Sciences, The Hong Kong Polytechnic University, Hung Hom, Hong Kong
| | - Chung-Ying Lin
- Chung-Ying Lin, Institute of Allied Health Sciences, College of Medicine, National Cheng Kung University, Tainan, Taiwan, Department of Occupational Therapy, College of Medicine, National Cheng Kung University, Tainan, Taiwan, and Department
of Public Health, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan;,
| | - Janet D. Latner
- Janet D. Latner, Department of Psychology, University of Hawaii at Manoa, Honolulu, HI, United States
| | - Kerry S. O'Brien
- Kerry S. O'Brien, School of Social Sciences, Faculty of Arts, Monash University, Melbourne, VIC, Australia
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Keirns NG, Tsotsoros CE, Addante S, Layman HM, Krems JA, Pearl RL, Janet Tomiyama A, Hawkins MA. Adverse Childhood Experiences Associated with Greater Internalization of Weight Stigma in Women with Excess Weight. OBESITIES 2021; 1:49-57. [PMID: 35463808 PMCID: PMC9033161 DOI: 10.3390/obesities1010005] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 12/05/2022]
Abstract
Adverse childhood experiences (ACEs) may be an early life factor associated with adult weight stigma via biological (e.g., stress response), cognitive (e.g., self-criticism/deprecation), and/or emotional (e.g., shame) mechanisms. This pilot study investigated relationships between ACEs and internalized and experienced weight stigma in adult women with overweight/obesity and explored differential relationships between weight stigma and ACE subtypes (i.e., abuse, neglect, household dysfunction). Adult women (68% white, M age = 33 ± 10 years, M BMI = 33.7 ± 7.2 kg/m2) completed measures of ACEs (ACE Questionnaire), internalized weight stigma (IWS; Weight Bias Internalization Scale-Modified; WBIS-M), and lifetime experiences of weight stigma (yes/no). Data were analyzed with linear and logistic regression (n = 46), adjusting for age, race, and body mass index (BMI). Linear regressions revealed a positive association between ACE and WBIS-M scores (β = 0.40, p = 0.006), which was driven by Abuse-type ACEs (β = 0.48, p = 0.009). Relationships between WBIS-M scores and Neglect- and Household-Dysfunction-type ACEs did not reach significance (β = 0.20, p = 0.173; β = -0.16, p = 0.273). Though descriptive statistics revealed greater rates of experienced weight stigma endorsement by those with high-3+ ACEs (81%) vs. medium-1-2 ACEs (67%) or low/no-0 ACEs (60%), ACE scores were not significantly associated with experienced weight stigma in logistic regression (Wald = 1.36, p = 0.244, OR = 1.324, 95%, CI = 0.825-2.125). ACEs may be an early life factor that increase the risk for internalizing weight stigma in adulthood. Larger studies should confirm this relationship and follow-up on descriptive findings suggesting a potential association between ACEs and experienced weight stigma.
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Affiliation(s)
- Natalie G. Keirns
- Department of Psychology, Oklahoma State University, 116 Psychology Building, Stillwater, OK 74078, USA
| | - Cindy E. Tsotsoros
- Department of Psychology, Oklahoma State University, 116 Psychology Building, Stillwater, OK 74078, USA
| | - Samantha Addante
- Department of Psychology, Oklahoma State University, 116 Psychology Building, Stillwater, OK 74078, USA
| | - Harley M. Layman
- Department of Psychology, Oklahoma State University, 116 Psychology Building, Stillwater, OK 74078, USA
| | - Jaimie Arona Krems
- Department of Psychology, Oklahoma State University, 116 Psychology Building, Stillwater, OK 74078, USA
| | - Rebecca L. Pearl
- Department of Clinical and Health Psychology, University of Florida, 1225 Center Drive, Gainesville, FL 32610, USA
- Center for Weight and Eating Disorders, Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, 3535 Market Street, Suite 3108, Philadelphia, PA 19104, USA
| | - A. Janet Tomiyama
- Department of Psychology, University of California, A623 Franz Hall, 501 Portola Plaza, Los Angeles, CA 90095, USA
| | - Misty A.W. Hawkins
- Department of Psychology, Oklahoma State University, 116 Psychology Building, Stillwater, OK 74078, USA
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Gerend MA, Patel S, Ott N, Wetzel K, Sutin AR, Terracciano A, Maner JK. A qualitative analysis of people's experiences with weight-based discrimination. Psychol Health 2021; 37:1093-1110. [PMID: 33979254 DOI: 10.1080/08870446.2021.1921179] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
OBJECTIVE The aim of this study was to describe people's day-to-day experiences with weight-based discrimination and to distill themes that shed new light on this phenomenon. DESIGN A qualitative study was conducted in 2019 using a purposive sampling strategy. A racially and ethnically diverse sample of 32 U.S. adult men and women with a body mass index ≥30 kg/m2 completed a semi-structured interview. RESULTS Primary types of interpersonal weight-based discrimination included offensive comments, negative assumptions, social rejection, and unwanted attention or bullying. Participants also encountered environmental sources of weight bias such as inadequate seating in public venues. Three higher order themes that cut across people's experiences with weight-based discrimination were identified: 1) the often-ambiguous nature of weight-based discrimination; 2) intersections between body weight and other social identities; and 3) the role of social comparison processes. CONCLUSION Findings provide a detailed portrait of people's everyday experiences with weight-based discrimination. These experiences often reflected widely held negative stereotypes about people with higher body weight and conveyed the socially devalued status of higher-weight individuals in society. Findings have important implications for future research and interventions aimed at reducing the harmful effects of weight-based discrimination on health and emotional wellbeing.
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Affiliation(s)
- Mary A Gerend
- Department of Behavioral Sciences and Social Medicine, College of Medicine, Florida State University, Tallahassee, Florida, USA
| | - Shefali Patel
- College of Medicine, Florida State University, Tallahassee, Florida, USA
| | - Nicholas Ott
- College of Medicine, Florida State University, Tallahassee, Florida, USA
| | - Karen Wetzel
- College of Medicine, Florida State University, Tallahassee, Florida, USA
| | - Angelina R Sutin
- Department of Behavioral Sciences and Social Medicine, College of Medicine, Florida State University, Tallahassee, Florida, USA
| | - Antonio Terracciano
- Department of Geriatrics, College of Medicine, Florida State University, Tallahassee, Florida, USA
| | - Jon K Maner
- Department of Psychology, College of Arts and Sciences, Florida State University, Tallahassee, Florida, USA
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Cullin JM. Implicit and explicit fat bias among adolescents from two US populations varying by obesity prevalence. Pediatr Obes 2021; 16:e12747. [PMID: 33191643 DOI: 10.1111/ijpo.12747] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/10/2020] [Revised: 10/12/2020] [Accepted: 10/14/2020] [Indexed: 11/28/2022]
Abstract
BACKGROUND Research shows that explicit (reported) and implicit (unconscious) bias are distinct constructs varying by socioecological context. Implicit bias better predicts poor health outcomes related to chronic psychosocial stress. OBJECTIVES Variation in fat bias was identified in two populations of adolescents in Indiana counties with relatively high (Lawrence) and low (Monroe) obesity prevalence. METHODS Adolescents (n = 185) aged 14-18 years were recruited October 2017-2018. Explicit fat bias was measured using the Attitudes Towards Obese Persons (ATOP) scale. Implicit fat bias was measured using the obesity attitude implicit association test (IAT). RESULTS Both samples scored high on the ATOP, indicating more positive reported attitudes towards persons with obesity, and scores did not differ between counties (P > .05) after adjusting for age, sex, ethnicity, and BMI-for-age percentile. Both samples demonstrated unconscious anti-fat bias, with Monroe exhibiting significantly higher IAT scores (ie, greater anti-fat bias) than Lawrence after controlling for confounders (P = .039). CONCLUSION Differences between explicit and implicit fat-bias were observed. Both samples reported positive attitudes towards obesity but also demonstrated unconscious anti-fat bias. Unconscious anti-fat bias was significantly higher in the county with lower prevalence of obesity, suggesting epidemiological context may influence implicit fat bias. Higher obesity prevalence may reduce unconscious anti-fat bias in a population or, alternatively, lower obesity prevalence may increase such bias.
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Affiliation(s)
- Jennifer M Cullin
- Department of Anthropology, Indiana University, Bloomington, Indiana, USA
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Auster-Gussman LA, Crim J, Mann TL. The soulless cycle: Social physique anxiety as a mediator of the relation between body mass index and exercise frequency. STIGMA AND HEALTH 2021; 6:192-199. [PMID: 35360191 PMCID: PMC8963126 DOI: 10.1037/sah0000291] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/09/2023]
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Fan CW, Liu CH, Huang HH, Lin CY, Pakpour AH. Weight Stigma Model on Quality of Life Among Children in Hong Kong: A Cross-Sectional Modeling Study. Front Psychol 2021; 12:629786. [PMID: 33967895 PMCID: PMC8100454 DOI: 10.3389/fpsyg.2021.629786] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2020] [Accepted: 03/12/2021] [Indexed: 11/14/2022] Open
Abstract
We proposed a model to examine the relationship among different types of weight-related stigmas and their relationship to quality of life (QoL). We recruited 430 dyads of elementary school children [mean age = 10.07 years; nboy = 241 (56.0%); noverweight = 138 (32.1%)] and their parents. Parents completed QoL instruments about their children assessing generic QoL and weight-related QoL. Children completed QoL instruments assessing generic QoL and weight-related QoL and stigma scales assessing experienced weight stigma, weight-related self-stigma, and perceived weight stigma. Experienced weight stigma was significantly associated with perceived weight stigma, and in turn, perceived weight stigma was significantly associated with weight-related self-stigma. However, experienced weight stigma was not directly associated with weight-related self-stigma. In addition, experienced stigma was negatively associated with both child-rated and parent-rated QoL. Perceived weight stigma was associated only with parent-rated weight-related QoL but not child-rated QoL. Self-stigma was associated with child-rated QoL but not parent-rated QoL. Moreover, perceived weight stigma and weight-related self-stigma were significant mediators in the association between body weight and children's QoL; experienced weight stigma was not a significant mediator. The study findings can be used to inform healthcare providers about the relationship among different types of stigmas and their influence on child-rated and parent-rated QoL and help them develop interventions to address the global trend of overweight/obesity in youth and pediatric populations.
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Affiliation(s)
- Chia-Wei Fan
- Department of Occupational Therapy, AdventHealth University, Orlando, FL, United States
| | - Chieh-Hsiu Liu
- National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Hsin-Hsiung Huang
- Department of Statistics and Data Science, University of Central Florida, Orlando, FL, United States
| | - Chung-Ying Lin
- Institute of Allied Health Sciences, College of Medicine, National Cheng Kung University, Tainan, Taiwan.,Department of Occupational Therapy, College of Medicine, National Cheng Kung University, Tainan, Taiwan.,Department of Public Health, National Cheng Kung University Hospital, College of Medicien, National Cheng Kung University, Tainan, Taiwan.,Department of Rehabilitation Sciences, Faculty of Health and Social Sciences, The Hong Kong Polytechnic University, Hung Hom, Hong Kong
| | - Amir H Pakpour
- Social Determinants of Health Research Center, Research Institute for Prevention of Non-communicable Diseases, Qazvin University of Medical Sciences, Qazvin, Iran.,Department of Nursing, School of Health and Welfare, Jönköping University, Jönköping, Sweden
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Siqueira BB, Assumpção MC, Barroso SM, Japur CC, Penaforte FRDO. Weight stigma and health – Repercussions on the health of adolescents and adults: integrative review of the literature. JORNAL BRASILEIRO DE PSIQUIATRIA 2021. [DOI: 10.1590/0047-2085000000324] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
ABSTRACT Objective To conduct an integrative review in order to understand the repercussions of the social stigma of overweight on the health of adults and adolescents. Methods The international protocol for systematic review and meta-analysis studies PRISMA was adopted to guide the writing of this review. The databases used were PubMed, Psycinfo, SciELO, Medline, Lilacs and Pepsic, considering studies published in the period from 2000 to 2020. Sixty-seven (67) articles were analyzed, and 4 categories emerged: repercussions on physical well-being; repercussions on social well-being; repercussions on mental well-being; and mixed category (physical and psychological impact). Results In the vast majority of studies analyzed, weight stigma had a negative impact on the different spheres that make up the health construct, that is, the physical, social and mental spheres. Conclusions The consequences of weight stigma are a source of intense suffering, with an impact that reduces the quality of life of individuals who experience stigmatization, involving physical, emotional and social aspects.
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Rathbone JA, Cruwys T, Jetten J. Non-stigmatising alternatives to anti-obesity public health messages: Consequences for health behaviour and well-being. J Health Psychol 2021; 27:1601-1614. [PMID: 33719629 DOI: 10.1177/1359105321999705] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
This project investigated how alternative non-stigmatising public health messages influence people's health behaviours and well-being, relative to traditional stigmatising weight-loss messages. We conducted three experimental studies (total N = 1281) that compared traditional weight-loss messages to weight-neutral messages (Study 1), weight-inclusive messages (Study 2) and size acceptance messages (Study 3). Results revealed that public health messages have differential effects on health behaviours and well-being, depending on the audience's BMI or perceived weight. However, campaigns that challenge weight stigma and promote body positivity have positive effects on some psychological indicators of health and well-being for people of all body sizes.
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de Kluiver H, Milaneschi Y, Jansen R, van Sprang ED, Giltay EJ, Hartman CA, Penninx BWJH. Associations between depressive symptom profiles and immunometabolic characteristics in individuals with depression and their siblings. World J Biol Psychiatry 2021; 22:128-138. [PMID: 32425087 DOI: 10.1080/15622975.2020.1761562] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
OBJECTIVES The present study examined associations between immunometabolic characteristics (IMCs) and depressive symptom profiles (DSPs) in probands with lifetime diagnoses of depression and/or anxiety disorders and their siblings. METHODS Data were from the Netherlands Study of Depression and Anxiety, comprising 256 probands with lifetime diagnoses of depression and/or anxiety and their 380 siblings. Measured IMCs included blood pressure, waist circumference, and levels of glucose, triglycerides, HDL cholesterol, CRP, TNF-α and IL-6. DSPs included mood, cognitive, somatic and atypical-like profiles. We cross-sectionally examined whether DSPs were associated with IMCs within probands and within siblings, and whether DSPs were associated with IMCs between probands and siblings. RESULTS Within probands and within siblings, higher BMI and waist circumference were associated with higher somatic and atypical-like profiles. Other IMCs (IL-6, glucose and HDL cholesterol) were significantly related to DSPs either within probands or within siblings. DSPs and IMCs were not associated between probands and siblings. CONCLUSIONS The results suggest that there is a familial component for each trait, but no common familial factors for the association between DSPs and IMCs. Alternative mechanisms, such as direct causal effects or non-shared environmental risk factors, may better fit these results.
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Affiliation(s)
- Hilde de Kluiver
- Department of Psychiatry, Amsterdam UMC, Department of Amsterdam Public Health research institute and Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Yuri Milaneschi
- Department of Psychiatry, Amsterdam UMC, Department of Amsterdam Public Health research institute and Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Rick Jansen
- Department of Psychiatry, Amsterdam UMC, Department of Amsterdam Public Health research institute and Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Eleonore D van Sprang
- Department of Psychiatry, Amsterdam UMC, Department of Amsterdam Public Health research institute and Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Erik J Giltay
- Department of Psychiatry, Leiden University Medical Center, Leiden, The Netherlands
| | - Catharina A Hartman
- Interdisciplinary Center Psychopathology and Emotion regulation (ICPE), University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Brenda W J H Penninx
- Department of Psychiatry, Amsterdam UMC, Department of Amsterdam Public Health research institute and Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
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Trojanowski PJ, Breithaupt L, Negi S, Wonderlich J, Fischer S. Lack of guilt, shame, and remorse following weight stigma expression: a real-time assessment pilot study. PeerJ 2021; 8:e10294. [PMID: 33391863 PMCID: PMC7761191 DOI: 10.7717/peerj.10294] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2020] [Accepted: 10/13/2020] [Indexed: 11/20/2022] Open
Abstract
Objective Weight stigma is pervasive and is associated with negative health and psychological outcomes. Few studies have examined weight stigma perpetration or the emotions individuals experience after perpetrating weight stigma. This study used experience sampling to explore the nature and frequency of weight stigma behaviors and cognitions and moral emotions (shame, guilt, remorse, pride) in the perpetrator following weight stigma perpetration. Methods Participants were college students (N = 31, 77.1% female). Participants completed baseline measures of anti-fat attitudes and one week of experience sampling phone prompts assessing: (1) weight stigma behaviors and cognitions and (2) moral emotions. Generalized estimating equation analyses were used to model trajectories of moral emotions after weight stigma events. Results Thirty-one participants reported 1,008 weight stigma events over 7.5 days. Feelings of guilt, shame, and remorse decreased after weight stigma perpetration. Individuals also reported feeling less proud after engaging in weight stigma. Conclusions Weight stigma occurs frequently as reported by perpetrators. A lack of remorse, guilt, and shame is evident in undergraduates after they express weight stigma; however, individuals in this study also reported feeling less pride after perpetration. This study highlights the need for future studies to explore the expression of weight stigma from the perspective of perpetrators instead of targets. Results highlight the pervasiveness and normative nature of weight stigma perpetration in everyday life and the need to better understand the emotional response following weight stigma perpetration as a potential mechanism of its perpetuation.
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Affiliation(s)
- Paige J Trojanowski
- Department of Psychology, George Mason University, Fairfax, VA, United States of America
| | - Lauren Breithaupt
- Department of Psychiatry, Massachusetts General Hospital and Harvard Medical School, Boston, MA, United States of America
| | - Sonakshi Negi
- Department of Psychology, George Mason University, Fairfax, VA, United States of America
| | - Joseph Wonderlich
- Department of Psychology, George Mason University, Fairfax, VA, United States of America
| | - Sarah Fischer
- Department of Psychology, George Mason University, Fairfax, VA, United States of America
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Psychological distress and quality of life in Iranian adolescents with overweight/obesity: mediating roles of weight bias internalization and insomnia. Eat Weight Disord 2020; 25:1583-1592. [PMID: 31673986 DOI: 10.1007/s40519-019-00795-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/15/2019] [Revised: 08/20/2019] [Accepted: 10/05/2019] [Indexed: 02/07/2023] Open
Abstract
PURPOSE To examine whether weight-related self-stigma (aka weight bias internalization) and insomnia are potential predictors of psychological distress and quality of life (QoL) among Iranian adolescents with overweight (OW)/obesity (OB). To examine whether weight-related self-stigma and insomnia are potential mediators in the relationship between excess weight and health outcomes of distress and QoL. METHODS All participants (n = 934; 444 males; mean age = 15.7 ± 1.2 years; zBMI = 2.8 ± 1.0) completed questionnaires on weight-related self-stigma and insomnia at baseline. Six months later, they completed questionnaires on psychological distress and QoL to assess health outcomes. Relationships among variables were tested using mediation analyses with bootstrapping method. RESULTS Weight-related self-stigma significantly mediated the effects of zBMI on psychological distress (effect = 0.22; bootstrapping SE = 0.09; 95% CI = 0.08, 0.45), psychosocial QoL (effect = - 0.64; bootstrapping SE = 0.19; 95% CI = - 1.10, - 0.32), and physical QoL (effect = - 1.35; bootstrapping SE = 0.54; 95% CI = - 2.43, - 0.26). Insomnia also significantly mediated the effects of zBMI on psychological distress (effect = 2.18; bootstrapping SE = 0.31; 95% CI = 1.61, 2.81), psychosocial QoL (effect = - 0.89; bootstrapping SE = 0.33; 95% CI = - 1.60, - 0.28), and physical QoL (effect = - 0.83; bootstrapping SE = 0.42; 95% CI = - 1.69, - 0.02). Full mediations were found in psychosocial QoL; partial mediations were found in psychological distress and physical QoL. CONCLUSIONS Weight-related self-stigma and insomnia were significant mediators in the effects of excess weight on health outcomes. Therefore, it is important to identify and treat weight-related self-stigma and insomnia for adolescents with OW/OB. LEVEL OF EVIDENCE Level V, cross-sectional descriptive study.
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Curll SL, Brown PM. Weight stigma and psychological distress: A moderated mediation model of social identification and internalised bias. Body Image 2020; 35:207-216. [PMID: 33049458 DOI: 10.1016/j.bodyim.2020.09.006] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/13/2020] [Revised: 09/15/2020] [Accepted: 09/15/2020] [Indexed: 01/31/2023]
Abstract
Links between weight stigma and negative health outcomes are well documented, but risk and protective factors remain unclear. In this study, 458 higher-weight Australian adults completed online self-report measures of perceived weight stigma, weight-based social identification (identity centrality), internalised weight bias, and psychological distress. Associations between these variables were investigated in line with the rejection-identification model and the social identity approach to health. Perceived stigma was positively associated with social identification and psychological distress. Simple mediation analysis showed a positive indirect effect of perceived stigma on psychological distress through social identification. However, moderated mediation analysis revealed that this indirect effect was dependent on internalised bias. Among participants who reported low internalised bias, social identification was associated with lower psychological distress; but for those with high internalised bias, this relationship was reversed. Findings suggest that perceived weight stigma, weight-based social identification, and internalised weight bias are key factors that should be considered together in the design and evaluation of interventions to improve the mental health of higher-weight individuals.
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Affiliation(s)
- Sonia L Curll
- Discipline of Psychology, Faculty of Health, University of Canberra, 11 Kirinari Street, Bruce, ACT, 2617, Australia.
| | - Patricia M Brown
- Discipline of Psychology, Faculty of Health, University of Canberra, 11 Kirinari Street, Bruce, ACT, 2617, Australia.
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Crocker KC, Domingo-Relloso A, Haack K, Fretts AM, Tang WY, Herreros M, Tellez-Plaza M, Daniele Fallin M, Cole SA, Navas-Acien A. DNA methylation and adiposity phenotypes: an epigenome-wide association study among adults in the Strong Heart Study. Int J Obes (Lond) 2020; 44:2313-2322. [PMID: 32728124 PMCID: PMC7644297 DOI: 10.1038/s41366-020-0646-z] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/16/2019] [Revised: 06/16/2020] [Accepted: 07/16/2020] [Indexed: 02/07/2023]
Abstract
BACKGROUND Elevated adiposity is often posited by medical and public health researchers to be a risk factor associated with cardiovascular disease, diabetes, and other diseases. These health challenges are now thought to be reflected in epigenetic modifications to DNA molecules, such as DNA methylation, which can alter gene expression. METHODS Here we report the results of three Epigenome Wide Association Studies (EWAS) in which we assessed the differential methylation of DNA (obtained from peripheral blood) associated with three adiposity phenotypes (BMI, waist circumference, and impedance-measured percent body fat) among American Indian adult participants in the Strong Heart Study. RESULTS We found differential methylation at 8264 CpG sites associated with at least one of our three response variables. Of the three adiposity proxies we measured, waist circumference had the highest number of associated differentially methylated CpGs, while percent body fat was associated with the lowest. Because both waist circumference and percent body fat relate to physiology, we focused interpretations on these variables. We found a low degree of overlap between these two variables in our gene ontology enrichment and Differentially Methylated Region analyses, supporting that waist circumference and percent body fat measurements represent biologically distinct concepts. CONCLUSIONS We interpret these general findings to indicate that highly significant regions of the genome (DMR) and synthesis pathways (GO) in waist circumference analyses are more likely to be associated with the presence of visceral/abdominal fat than more general measures of adiposity. Our findings confirmed numerous CpG sites previously found to be differentially methylated in association with adiposity phenotypes, while we also found new differentially methylated CpG sites and regions not previously identified.
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Affiliation(s)
- Katherine C Crocker
- Department of Environmental Health Sciences, Mailman School of Public Health, Columbia University, New York, NY, USA.
| | - Arce Domingo-Relloso
- Department of Environmental Health Sciences, Mailman School of Public Health, Columbia University, New York, NY, USA
| | - Karin Haack
- Texas Biomedical Research Institute, San Antonio, TX, USA
| | - Amanda M Fretts
- Department of Epidemiology, University of Washington School of Public Health, Seattle, WA, USA
| | - Wan-Yee Tang
- Department of Environmental Health and Engineering, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
| | - Miguel Herreros
- Institute for Biomedical Research Hospital Clinic de Valencia (INCLIVA), Valencia, Spain
| | - Maria Tellez-Plaza
- Department of Chronic Disease Epidemiology, National Center for Epidemiology, Carlos III Health Institute, Madrid, Spain
| | - M Daniele Fallin
- Department of Environmental Health and Engineering, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
| | - Shelley A Cole
- Texas Biomedical Research Institute, San Antonio, TX, USA
| | - Ana Navas-Acien
- Department of Environmental Health Sciences, Mailman School of Public Health, Columbia University, New York, NY, USA
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Al-Rubaye AKQ, Johansson K, Alrubaiy L. The association of health behavioral risk factors with quality of life in northern Sweden-A cross-sectional survey. J Gen Fam Med 2020; 21:167-177. [PMID: 33014667 PMCID: PMC7521790 DOI: 10.1002/jgf2.333] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2020] [Revised: 04/21/2020] [Accepted: 04/27/2020] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND It is well known that behavioral risk factors such as obesity, smoking, physical activity, diet, and excessive alcohol are linked to general health in northern Sweden. This study aimed to explore the joint relationship between these risk factors and the quality of life (QoL). METHODS Data were collected from Sweden's national public health survey between February and May 2014 in the four northern counties in Sweden. QoL was assessed using the EuroQol (EQ-5D). Multivariable regression analysis was used to examine the relationship between five risk factors: BMI, physical activity, smoking status, fruit and vegetable intake, and alcohol consumption and QoL. RESULTS Data from 17 138 complete questionnaires showed that individuals who were not obese, did at least 30 minutes of physical activity daily, consumed at least 3 portions of vegetable or fruits, were not smoking daily, and who did not report being drunk at least once every week were found to have better QoL (P < .005). The mean EQ-5D score ranged from 0.85 to 0.79. Approximately, two thirds of the studied population reported being physically active for at least 30 minutes every day and two fifths of them had a normal BMI. Only around 7% of the sample reported that they were eating the recommended daily level of fruits and vegetables. CONCLUSIONS The results of the study suggest that QoL has a significant relationship with lifestyle behaviors. This finding would emphasize the role of interventions to improve population health.
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Affiliation(s)
| | - Klara Johansson
- Department of Epidemiology and Global Health Umeå University Umeå Sweden
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Gerend MA, Sutin AR, Terracciano A, Maner JK. The role of psychological attribution in responses to weight stigma. Obes Sci Pract 2020; 6:473-483. [PMID: 33082989 PMCID: PMC7556435 DOI: 10.1002/osp4.437] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2020] [Revised: 05/31/2020] [Accepted: 06/07/2020] [Indexed: 11/24/2022] Open
Abstract
Objective Weight discrimination is associated with numerous negative health consequences. Little is known about early‐stage psychological mechanisms that explain variability in responses to weight discrimination among people with obesity. This study tested the hypothesis that attributing negative social evaluation to one's weight would be associated with stigma‐related stress responses (eg, reduced cognitive functioning and self‐esteem, increased negative affect and cortisol), especially among people who had experienced frequent weight discrimination in the past. Methods Adults (N = 109) with obesity were randomly assigned to receive a mildly positive (control) versus negative social evaluation. The extent to which participants attributed the negative evaluation to their physical appearance was assessed, along with negative affect, social and appearance self‐esteem, cognitive functioning and salivary cortisol. Results Participants who had experienced frequent weight discrimination in the past were more likely to attribute the negative evaluation to their appearance. Participants who attributed the negative evaluation to their appearance in turn experienced elevated negative affect, lower appearance self‐esteem and worse cognitive functioning. Conclusions This study is among the first to identify attribution as an early‐stage process underlying responses to weight stigma. Attribution may be a key psychological factor conferring risk for or protection from the negative effects of weight stigma.
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Affiliation(s)
- Mary A Gerend
- Department of Behavioral Sciences and Social Medicine, College of Medicine Florida State University Tallahassee Florida USA
| | - Angelina R Sutin
- Department of Behavioral Sciences and Social Medicine, College of Medicine Florida State University Tallahassee Florida USA
| | - Antonio Terracciano
- Department of Geriatrics, College of Medicine Florida State University Tallahassee Florida USA
| | - Jon K Maner
- Department of Psychology, College of Arts and Sciences Florida State University Tallahassee Florida USA
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Gordon AM, Prather AA, Dover T, Espino-Pérez K, Small P, Major B. Anticipated and Experienced Ethnic/Racial Discrimination and Sleep: A Longitudinal Study. PERSONALITY AND SOCIAL PSYCHOLOGY BULLETIN 2020; 46:1724-1735. [DOI: 10.1177/0146167220928859] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
The transition to college is a stressful experience. For members of underrepresented minority groups, the usual stresses are frequently accompanied by ethnicity-based stressors, including discrimination. This longitudinal study extends prior work on discrimination by examining the prospective associations between anticipated and experienced ethnic/racial discrimination and sleep, a ubiquitous and basic biological need critical for optimal functioning. In a sample of 274 low-income/first-generation Latinx students, results from a cross-lagged panel model revealed that both the anticipation and experience of discrimination at the beginning of college uniquely predicted worsening sleep quality over the second half of freshmen year, controlling for relevant covariates. There was also some evidence for bidirectionality, with poor sleepers experiencing more discrimination. These findings add to the literature linking discrimination and sleep, both of which play large roles in mental, physical, social, and academic outcomes.
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Affiliation(s)
- Amie M. Gordon
- University of California San Francisco, USA
- University of Michigan, Ann Arbor, USA
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Manokaran R, Pausé C, Roßmöller M, Vilhjálmsdóttir TM. ‘Nothing about us without us’: Fat people speak. QUALITATIVE RESEARCH IN PSYCHOLOGY 2020. [DOI: 10.1080/14780887.2020.1780355] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Affiliation(s)
| | - Cat Pausé
- Massey University, Palmerston North, New Zealand
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